Should advanced age alone be considered a contraindication to systemic lymphadenectomy in gynecologic oncologic patients? A university hospital experience in Turkey

In this case-control study, we aimed at analyzing the effect of pelvic and paraaortic lymphadenectomy on intraoperative and postoperative morbidity and mortality rates in a series of elderly patients (age greater than or equal to 65 years) with gynecologic malignancies. We examined preexisting medical conditions, surgical data, intraoperative and postoperative morbidity and mortality in 37 patients aged 65 years or older with endometrial and ovarian carcinoma who underwent pelvic and paraaortic lymphadenectomy. Control group consisted of patients between 60 and 64 years with similar malignancies. The number of patients with hypertension (P = 0.03), minor (P = 0.01) and major cardiac problems (P = 0.03), chronic obstructive lung disease (P = 0.02), and history of cerebrovascular disease (P = 0.04) were significantly higher in the study group than that in control. The median operative time was significantly shorter (160 min) in the study group than that (191 min) in control (P = 0.004). There were no significant differences between the groups with regard to blood loss, intraoperative and postoperative blood transfusion, preoperative and postoperative hemoglobin levels, yielded lymph nodes, and postoperative stay. Minor and major intraoperative and postoperative complications were not different between the groups. In these elected elderly patients, we demonstrate that pelvic and paraaortic lymph node dissection can be performed with an acceptable morbidity and mortality. We should perform pelvic and paraaortic lymphadenectomy in the older aged patients and advanced aged should not be considered a contraindication.