Key result
Older age linked to ~79% higher risk of major complications after ovarian cancer surgery.
Why the study?
Elderly patients with ovarian cancer commonly receive modified treatment due to an assumption of higher risk, prompting evaluation of their postoperative complications after surgery.
Does older age increase the risk of postoperative complications in patients undergoing surgery for ovarian cancer?
Cohort (n=11,108)
Yes
Does older age increase the risk of postoperative complications in patients undergoing surgery for ovarian cancer?
Odds Ratio: 1.79 (95% CI 1.38–2.31)
Absolute Event Rate: 3.5% vs 2%
p-value: p=< 0.0001
Elderly patients undergoing surgery for ovarian cancer have a significantly higher risk of major postoperative complications and are less likely to be discharged home compared to younger patients.
Supports cautious perioperative planning for ovarian cancer surgery in patients ≥70 years; leaves open whether targeted interventions reduce complications.
BACKGROUND AND OBJECTIVES: Elderly patients with ovarian cancer (OC) commonly receive modified treatment due to the assumption of higher risk. The aim of this study is to evaluate postoperative complications in elderly patients undergoing surgery for OC. METHODS: Retrospective cohort study of patients with OC identified in the NSQIP database, (2013-2021). Younger patients included 40-69 years old, and elderly patients were ≥ 70 years old. Major complications included: pulmonary embolism, deep vein thrombosis, acute kidney injury, stroke, cardiac arrest, space surgical site infection, myocardial infarction, sepsis, septic shock, and return to the operating room. RESULTS: Of the 11,108 patients, 8214 (74%) were in the younger patient and 2894 (26%) in the elderly patient group. Elderly patients had higher rates of postoperative pneumonia (2.6% vs. 1.2%), myocardial infarction (1.4% vs. 0.3%), and major complications (3.5% vs. 2.0%), p < 0.0001 for all. Discharge to rehab was higher in elderly patients (3.1% vs. 0.5%, p < 0.001). On multivariate logistic regression, older age was associated with "major complications" (aOR 1.79, 95% CI 1.38-2.31, p < 0.0001). CONCLUSIONS: In OC patients selected for surgery, elderly patients are at higher risk of Postoperative complications and are less likely to be discharged home. This should be considered when counseling patients pre-operatively and planning for peri-operative care and disposition.
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Salman et al. (2025) conducted a cohort in Ovarian cancer (n=11,108). Older age (≥ 70 years) vs. Younger age (40-69 years) was evaluated on Major complications (aOR 1.79, 95% CI 1.38-2.31, p=< 0.0001). Older age (≥ 70 years) was associated with a higher risk of major postoperative complications compared to younger patients undergoing ovarian cancer surgery (3.5% vs 2.0%; aOR 1.79, 95% CI 1.38-2.31).
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