Surgery in older patients

Surgery for solid tumors is often withheld from the very elderly because of perceptions that they could not tolerate it physically and often because their life expectancy is considered too short. Data have shown that both of these factors should be carefully considered for the individual patient, since the mortality from most operations, even such major surgeries as liver resections, is no different for the fit elderly than for younger patients. One of the main problems is that the elderly are often not diagnosed and treated early enough to prevent emergency operations that carry a much higher mortality. Many new surgical techniques have made cancer surgery less invasive; this is especially true for stage I and II breast cancer. These advances have increased the potential for curative cancer surgeries that can be offered to all patients regardless of advanced age. © 2004 Elsevier Inc. All rights reserved.