title: Outcomes of octogenarians undergoing gastrectomy performed for malignancy.
abstract: Studies on perioperative outcomes of octogenarians with gastric cancer are limited by small sample size. Our aim was to determine the outcomes of gastrectomy and the variation of treatments associated with advanced age (≥80 y).
  
  
  
  The National Surgical Quality Improvement Program database was queried from 2005 to 2011. Patients who underwent gastrectomy for malignancy were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes.
  
  
  
  Of 2591 cases, 487 patients were octogenarians (≥80) and 2104 were nonoctogenarians (<80). Overall, 4.9% of patients had disseminated cancer. Octogenarians had higher 30-d mortality (7.2% versus 2.5%, P < 0.01) and more major complications (31.4% versus 25.5%, P < 0.01), though fewer octogenarians underwent total gastrectomy (24.0% versus 43.2%, P < 0.01) and extended lymphadenectomy (10.1% versus 17.4%, P < 0.01) than the nonoctogenarian cohort. On multivariate analysis, age ≥80 y was associated with major complications (OR, 1.3; 95% CI, 1.03-1.6; P = 0.03) and increased mortality (OR, 3.0; 95% CI, 1.9-4.9; P < 0.01).
  
  
  
  Advanced age (≥80 y) was associated with worse outcomes in patients undergoing gastrectomy for malignancy. Therefore, careful staging is necessary to reduce unnecessary operations in this population. Furthermore, surgeons must place greater attention on optimizing the octogenarian population before surgery.
authors.affiliation: Department of Surgery, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York. Electronic address: anteng@chpnet.org.
authors.forename: Annabelle
authors.initials: A
authors.lastname: Teng
authors.affiliation: Department of Surgery, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Bellini
authors.affiliation: Department of Surgery, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York.
authors.forename: Erica
authors.initials: E
authors.lastname: Pettke
authors.affiliation: Department of Surgery, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Passeri
authors.affiliation: Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California.
authors.forename: David Y
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Critical Care, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York.
authors.forename: Keith
authors.initials: K
authors.lastname: Rose
authors.affiliation: Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California.
authors.forename: Anton J
authors.initials: AJ
authors.lastname: Bilchik
authors.affiliation: Department of Surgery, Mount Sinai St. Luke's Roosevelt Hospital, New York, New York.
authors.forename: Fadi
authors.initials: F
authors.lastname: Attiyeh
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP); Elderly; Gastrectomy; Gastric cancer; Octogenarian