BACKGROUND: Advanced patient age may be considered a contraindication to referring elderly patients with gastrointestinal malignancies for surgical intervention. Our goal was to determine whether elderly cancer patients 80 years of age are able to safely undergo major abdominal surgical procedures and derive a clinical benefit.
METHODS: We conducted a retrospective study of all patients 80 years of age who underwent a major oncologic procedure with curative intent between June 1990 and July 1999.
RESULTS: 111 patients fit the above criteria with 16 excluded due to insufficient follow up. Of the 95 patients evaluated, 62 had standard intestinal resections (SR) for cancer of the colon (n = 59) or small bowel (n = 3). 33 patients, 18 male and 15 female with a mean age 83.8 ± 3.5 years, underwent major oncologic resections (MR) that included 13 low anterior resections and 4 abdominoperineal resections for rectal cancer. 2 patients had an esophagectomy and 5 had a gastrectomy for adenocarcinoma of the esophagus and stomach, respectively. 9 patients underwent a pancreaticoduodenectomy for cancer of the pancreas, duodenum, or bile duct. 38.7% of the MR patients had documented coronary artery disease and 25.8% had a previous cancer diagnosis. The median hospital stay was 11 ± 2.2 days in the MR group and 9 ± 4.8 days in the SR group. The median overall survival was 25 and 27 months and the median disease free survival was 22 and 26 months in the MR and SR groups, respectively. With a median follow up of 20.9 months, the three year overall and disease free survival for the MR patients were 60.4 ± 10.2% and 76.2 ± 9.8% respectively. Evaluating all 95 patients 80 years of age, 16.8% had complications and 3 patients (3.2%) died in the perioperative period.
CONCLUSIONS: These data suggest that selected patients aged 80 years of age are able to undergo a major abdominal cancer operation with curative intent with an acceptable perioperative morbidity and mortality. Advanced age alone should not be a contraindication to major oncologic resections.