title: Surgical treatment of gastrointestinal carcinomas in octogenarians: risk factors for complications and long-term outcome.
abstract: 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.
authors.affiliation: U.O. Chirurgia Oncologica, University of Siena, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Marrelli
authors.forename: F
authors.initials: F
authors.lastname: Roviello
authors.forename: A
authors.initials: A
authors.lastname: De Stefano
authors.forename: G
authors.initials: G
authors.lastname: Vuolo
authors.forename: C
authors.initials: C
authors.lastname: Brandi
authors.forename: M
authors.initials: M
authors.lastname: Lottini
authors.forename: E
authors.initials: E
authors.lastname: Pinto
mesh_terms: 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
chemical_list: D012709:Serum Albumin; D003404:Creatinine