Surgical treatment of gastrointestinal carcinomas in octogenarians: risk factors for complications and long-term outcome.
BACKGROUND
The aims of this retrospective study were to determine the factors predictive of morbidity and mortality, and to evaluate the probability of long-term survival in octogenarians with carcinomas of the gastrointestinal tract.


METHODS
Out of a total of 194 patients, aged 80 years or over, with histologically diagnosed carcinoma of the stomach or colon-rectum, observed between 1987 and 1995, 167 underwent surgery and were included in this study. The relationship between a series of clinico-pathological variables and morbidity/mortality rates was investigated by univariate and multivariate analysis. Complete follow-up data were available in 161 patients.


RESULTS
Fifty-nine patients (35.3%) experienced complications and 14 (8.4%) died during hospitalization. Statistical analysis identified hypoalbuminaemia (P<0.01, relative risk (RR)=2.92) and hypercreatininaemia (P<0.05, RR=3.59) as independent predictors of post-operative complications. Hypercreatininaemia (P<0.05, RR=5.22) and non-curative surgery (P<0. 05, RR=3.99) significantly affected operative mortality. Crude 5-year survival rate, including operative mortality after curative surgery, was 41% in gastric cancer and 39% in colorectal cancer patients.


CONCLUSIONS
These results indicate that surgery for gastrointestinal carcinomas yields an acceptable operative risk in octogenarians, and provides good long-term results if oncological radicality can be obtained. Pre-operative evaluation of tumour stage and patient's general condition is useful to identify subgroups of patients at high risk of surgical complications and mortality.
Marrelli
D
D
U.O. Chirurgia Oncologica, University of Siena, Italy.
Roviello
F
F
De Stefano
A
A
Vuolo
G
G
Brandi
C
C
Lottini
M
M
Pinto
E
E
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002277:Carcinoma / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000097:blood / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D012306:Risk; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013274:Stomach Neoplasms / Q000097:blood / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
D012709:Serum Albumin; D003404:Creatinine