Preoperative Risk Assessment
Surgical excision and/or cytoreduction currently represent the treatment of choice for most gynecological tumors, regardless of the patients’ age. A robust body of evidence supports this. Despite operative complications and mortality, long-term cancer-related survival may be significantly improved by an aggressive surgical approach in the older age group as it is for younger women.
As older patients are characterized by a marked heterogeneity that increases with advancing age, it is important to establish preoperatively whether the older surgical patient is fit or has limited physiological reserves. Elements of a geriatric assessment, such as functional status including gait speed, comorbidity, nutritional status, depression, and cognitive function have all been found to be associated with post-operative morbidity. Some of these factors may be optimized before surgery. Thus, adding geriatric assessment to the standard preoperative protocol in older women with gynecological cancers may provide a more precise risk assessment and guide preoperative interventions.
KeywordsPreoperative risk Comorbidity Gynecological cancer Cytoreduction Geriatric oncology
- 18.Kristjansson SR, Nesbakken A, Jordhov MS, Audisio RA, Johannessen HO, Bakka A, Wylier TB, Jordhoy MS and Wyller TB. Crit Rev Oncol Hematol. Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study. Curr Rev Oncol Hematol. 2010;76(3):208–17.CrossRefGoogle Scholar
- 23.Berek JS, Hacker NF. Practical gynecologic oncology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.Google Scholar