VALIDITY OF MAJOR CANCER OPERATIONS IN ELDERLY PATIENTS

Background: As the population ages, more elderly individuals will be at risk for the development of gastrointestinal malignancies traditionally treated with radical operation. In the past, many major cancer operations were reserved for patients < 65 or 70 years of age, but as the life expectancy for a 70-year-old has improved, this policy has been questioned. Methods: We examined the records of 124 consecutive patients who underwent one of three major operations (esophagogastrectomy, major liver resection, pancreatoduodenectomy) for gastrointestinal cancer during the past 6 years to determine if preoperative risk factors, operative mortality, length of stay, length of procedure, estimated blood loss, rate of major complication, or Kaplan-Meier survival was different for patients greater than or equal to 70 years of age as compared with younger patients. Results: For patients at our institution undergoing esophagogastrectomy, major liver resection, or pancreatoduodenectomy, we found no significant difference in any of the parameters measured. There was no significant difference in any parameter when comparing patients greater than or equal to 70 versus < 70 years of age. Conclusions: We conclude that patients greater than or equal to 70 years of age are not necessarily less suitable candidates for major cancer operations than are those < 70 years of age if other risk factors are acceptable. Elderly patients should be included in clinical trials.