Introduction/Background Despite the progressive reduction in surgical morbidity of vulvar cancer, the incidence of post-operative complications remains high, especially in patients with comorbidities such as tumour stage, advanced age, diabetes, hypertension, obesity, smoking or hypoalbuminaemia. Assessing these conditions in addition to patient‘s strength, function and physiological endurance would provide a more global view of the patient‘s functional status.
The aim of this study is to review the complications and their relationship with frailty in patients who underwent surgery for vulvar cancer at our Centre.
Methodology Retrospective study of vulvar cancer cases operated between 2009–2022 to analyze the relationship of frailty (using the modified frailty index, mFI) and post-operative complications. Statistical analysis of the frequency distribution of the population data as well as postoperative complications according to frailty status was performed. Differences between percentages were calculated with Fisher’s exact test.
Results Of 31 women who underwent radical vulvectomy (22.6% RV alone), 12 cases (38.7%) had mFI≥2 (frail). No differences were found between frail and non-frail groups in the type of surgery nor stage. Women with an mFI≥2 compared with non-frail women were older (≥65yrs: 100% vs 52.6%, p<0.05), more diabetes cases (50% vs 0, p<0.05), hypertension (83.3 vs 26.7 p<0.05) and functional dependence (91.7% vs 10.5%, p<0.05). Post-operative complications in frail women were found in 75% of cases against 47.4% in non-frail group. It was found significant difference in minor complications (75% vs 31.6% p<0.05). Major complications were 33.3% in frail group vs 5.6% in non-frail (p=0.06). Wound complications were 75% in frail women vs 47.4% in non-frail (of these, wound vulvar disruption was found in frail group 66.7% vs 5.3% in non-frail, p=0.06>).
Conclusion Despite the small number of cases in our cohort, frailty is observed to have a higher risk of complications after surgical treatment of vulvar cancer.
Disclosures This research received no external funding. The authors declare no conflict of interest.
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