Introduction/Background Indication of surgery for ovarian cancer (OC) is often influenced by patients’ age, as older individuals are presumed to have lower tolerance for radical surgery. However, limited evidence exists on whether the surgical risks outweigh the benefits of surgery in elderly patients. We aimed to compare perioperative complications between elderly patients (EP) and non-elderly patients (NEP) undergoing surgery for OC.

Methodology This retrospective single-center observational study includes consecutive women undergoing surgery for OC between January 2018 and September 2023. Patients were classified as NEP (<75 years) or EP (≥75 years). Chi-square, Fisher’s exact, Student-T, or Mann-Whitney tests were used to compare groups. Kaplan-Meier analysis assessed survival.

Results 103 patients were included: 28 EP and 75 NEP. No differences were observed in disease characteristics. Staging surgery was performed in 37 patients, primary debulking in 34, and interval debulking in 32, with no differences in type of surgery between EP and NEP (p=0.283). Operative time was shorter in EP (232.3 vs.273.9 minutes; p=0.021).

Intra-operative (3.6% vs.13.3%, p=0.281) and post-operative (42.9% vs.33.3%, p=0.489) complication rates were not different between EP and NEP. However, severe complications (Clavien-Dindo III-V) occurred more frequently in EP (35.7% vs.12.0%, p=0.010). EP required reintervention more often than NEP (25% vs.6.7%, p=0.016). The higher rate of severe complications did not delay start of chemotherapy in EP (47.4 days vs.40.7 days in NEP, p=0.060). After a mean follow-up of 26 months, EP presented significantly worse overall survival than NEP (32.7 vs.66.7 months, p<0.001), while no differences were observed in progression-free survival (29.7 vs.33.7 months, p=0.920 ).

Conclusion EP undergoing OC surgery do not present a higher rate of perioperative complications compared to NEP. Severe complications are more frequent among EP, who require reintervention more often than NEP. The increased rate of severe complications does not significantly delay adjuvant treatment in EP.

Disclosures Authors have no conflict of interest to declare.