Validity of major cancer operations in elderly patients.
BACKGROUND
As the population ages, more elderly individuals will be at risk for the development of gastrointestinal malignancies traditionally treated with radical operation. In the past, many major cancer operations were reserved for patients < 65 or 70 years of age, but as the life expectancy for a 70-year-old has improved, this policy has been questioned.


METHODS
We examined the records of 124 consecutive patients who underwent one of three major operations (esophagogastrectomy, major liver resection, pancreatoduodenectomy) for gastrointestinal cancer during the past 6 years to determine if preoperative risk factors, operative mortality, length of stay, length of procedure, estimated blood loss, rate of major complication, or Kaplan-Meier survival was different for patients > or = 70 years of age as compared with younger patients.


RESULTS
For patients at our institution undergoing esophagogastrectomy, major liver resection, or pancreatoduodenectomy, we found no significant difference in any of the parameters measured. There was no significant difference in any parameter when comparing patients > or = 70 versus < 70 years of age.


CONCLUSIONS
We conclude that patients > or = 70 years of age are not necessarily less suitable candidates for major cancer operations than are those < 70 years of age if other risk factors are acceptable. Elderly patients should be included in clinical trials.
Karl
R C
RC
Department of Surgery, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa 33612, USA.
Smith
S K
SK
Fabri
P J
PJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004386:Duodenum / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D005431:Florida / Q000453:epidemiology; D005743:Gastrectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors