Radical hysterectomy for cervical cancer: morbidity and survival in relation to weight and age.
The records of 123 patients with Stage I cervical cancer who underwent radical hysterectomy with pelvic lymphadenectomy and para-aortic node sampling from 1981 to 1988 were reviewed to assess the risks of surgery associated with increasing weight and age. Fifty-four patients were obese (20% or more over ideal body weight) and fourteen were elderly (age 65 or older). Previous abdominal/pelvic surgery and operative time were significantly increased in the obese patients (P less than 0.05). Increased weight was associated with increased blood loss (P = 0.06). Medical illnesses, transfusion rates, postoperative stay, intraoperative and postoperative complications (including wound infection and separation), long-term complications, and 5-year survival rates were not significantly different in obese and nonobese women. Diabetes mellitus, hypertension, any medical illness, intraoperative complications (29% vs 3%), and postoperative ileus were significantly higher (P less than 0.05) in elderly patients. However, operative time, blood loss, transfusion rates, postoperative stay, postoperative complications (exclusive of ileus), long-term complications (13-21%), and 5-year survival rates (77-99%) were not significantly different when analyzed by age. We found no significant increase in morbidity of radical hysterectomy for Stage I cervical cancer in the obese patient and minimally increased morbidity in the elderly patient with no increase in long-term complications or decrease in survival. Obesity should not represent a contraindication to radical surgery in appropriately selected patients with cervical cancer.
Levrant
S G
SG
Department of Obstetrics and Gynecology, SUNY Health Science Center, Brooklyn 11203-2098.
Fruchter
R G
RG
Maiman
M
M
D000375:Aging / Q000502:physiology*; D001803:Blood Transfusion; D001835:Body Weight; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007044:Hysterectomy; D007431:Intraoperative Complications; D007432:Intraoperative Period; D007902:Length of Stay; D009017:Morbidity; D011183:Postoperative Complications; D016019:Survival Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*