Retrospective analysis of surgical outcomes and prognosis in elderly patients with gynecologic cancers

With the progressive aging of the population, the number of elderly patients with gynecologic malignancies is steadily increasing. Due to the presence of multiple comorbidities and diminished postoperative recovery capacity, this population is associated with considerable variability in surgical outcomes, highlighting the urgent need for optimized perioperative management. This study aimed to investigate key factors influencing postoperative recovery quality and 1-year prognosis in elderly patients with gynecologic cancers, in order to provide evidence for individualized clinical management. A total of 132 elderly patients (aged ≥ 65 years) who underwent surgical treatment for gynecologic malignancies at our hospital between January 2023 and May 2024 were retrospectively enrolled. Based on postoperative recovery quality and recurrence/survival status within 1 year, patients were categorized into a good prognosis group (n = 68) and a poor prognosis group (n = 64). Baseline characteristics, intraoperative parameters, postoperative recovery indicators, and long-term outcomes were compared between the 2 groups. Logistic regression analysis was performed to identify independent risk factors associated with poor prognosis. There were no statistically significant differences in baseline characteristics between the 2 groups, indicating good comparability. The proportion of laparoscopic surgeries was higher in the good prognosis group, and both intraoperative blood loss and operative time were significantly lower compared to the poor prognosis group (P < .05). The incidence of postoperative complications was significantly higher in the poor prognosis group (40.6% vs 19.1%, P = .006), along with prolonged hospital stay and delayed functional recovery (P < .05). One-year recurrence and overall survival rates also differed significantly between the groups (recurrence: 32.8% vs 10.3%, P = .002; survival: 71.9% vs 91.2%, P = .004). Multivariate logistic regression analysis identified intraoperative blood loss > 500 mL (OR = 2.36, P = .019) and postoperative complications (OR = 3.12, P = .003) as independent predictors of poor prognosis. The postoperative prognosis of elderly patients with gynecologic cancers is influenced by multiple factors, among which intraoperative bleeding control and complication management are critical intervention points. Preoperative risk assessment, surgical optimization, enhanced perioperative care, and structured postoperative rehabilitation should be emphasized to improve recovery quality and long-term survival in this high-risk population.