Radical Hysterectomy in the Elderly Female: A Comparison to Patients Age 50 or Younger

Background. Longevity in the United States is increasing, therefore the knowledge of whether radical surgery can be performed on patients over age 65 with acceptable morbidity and mortality is increasingly important. A retrospective study of elderly patients undergoing radical hysterectomy was performed with a comparison to a younger cohort. Methods. A retrospective case study of all patients over 65 years of age having undergone a radical hysterectomy for cervical cancer in one practice of gynecologic oncology was performed. Each patient was matched with two patients age 50 or younger having undergone a similar operation during the same year. No patients between July 1, 1965, and March 31, 1998, were knowingly excluded. All patients were analyzed for preexisting medical conditions, length of postoperative stay, morbidity, and postoperative mortality. Results. Sixty-two patients over age 65 having undergone a radical hysterectomy and pelvic lymphadenectomy were found. These patients were matched with 124 patients age 50 or younger having undergone a radical hysterectomy during the same calendar year. No differences in operative morbidity (minor, P > 0.57; major, P > 0.93) or mortality (no deaths in either group) were found. Patients age 65 or older had more comorbidities prior to surgery than the younger cohort (minor, P < 0.001; major, P < 0.001). The mean postoperative hospital stay was significantly longer in the older cohort (P = 0.005). Conclusions. Radical hysterectomy is a safe surgical procedure in a select population of patients 65 and over. No differences in operative mortality or morbidity were found when compared to a cohort of patients age 50 or younger. However, hospital stay was longer in the older cohort.