title: Pelvic exenteration: impact of age on surgical and oncologic outcomes.
abstract: OBJECTIVE
  To evaluate whether preoperative age impacts surgical outcomes, complication rates, and/or recurrence in women undergoing pelvic exenteration.
  
  
  METHODS
  All women who underwent a pelvic exenteration for any gynecologic indication at our institution from 1993 to 2010 were included. Women were stratified into groups based on age in years (young: ≤ 50, middle: 51-64, and senior: ≥ 65). Baseline characteristics, surgical outcomes, early (<60 days) and late (≥ 60 days) postoperative complications, and recurrence/survival outcomes were ascertained. Fisher's exact test or Kruskal-Wallis test was performed. Kaplan-Meier survival curves were compared.
  
  
  RESULTS
  161 patients were included (58 young, 62 in the middle, and 41 senior). Women in the young group predominately had a diagnosis of cervical cancer (82.8%) while women in the senior group primarily had a diagnosis of vulvar or vaginal cancer (70.7%). Senior women were also more likely to have hypertension (p < 0.0001) and pulmonary disease (p = 0.040). Operative time was significantly shorter for women in the senior group (8.5h) compared with the middle (9.5h) and young group (10.1h) (p = 0.0089). There were no significant differences in early or late complications when stratified by age. The overall survival did not differ between age groups (p = 0.3760).
  
  
  CONCLUSIONS
  Although hypertension and pulmonary disease were more frequent in the senior age group, duration of surgery, blood loss, length of hospital stay and complication rates did not increase with age. Advanced chronological age should not be considered a contraindication to a potentially curative surgical procedure.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Science, Magee-Women's Hospital of UPMC, Pittsburgh, PA 15213, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Iglesias
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Shannon N
authors.initials: SN
authors.lastname: Westin
authors.affiliation: Department of Biostatistics, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Fellman
authors.affiliation: Department of Biostatistics, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Urbauer
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Schmeler
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Frumovitz
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address: psoliman@mdanderson.org.
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000379:methods*; D016896:Treatment Outcome
keywords: Age; Gynecologic cancer; Pelvic exenteration