TITLE

Advanced Age Does Not Contribute to Increased Risks or Poor Outcome after Major Abdominal Operations

AUTHOR(S)
Blair, Sarah L.; Schwarz, Roderiche E.
PUB. DATE
December 2001
SOURCE
American Surgeon;Dec2001, Vol. 67 Issue 12, p1123
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Elderly patients are still frequently denied major operations out of concerns over increased morbidity. The impact of advanced age on morbidity, mortality, and late outcomes after major gastric and pancreatic resections was studied by retrospective review with Chi square and regression analysis. Between July 1987 and June 2000, 179 patients underwent a major gastrectomy or pancreatectomy procedure at the City of Hope Cancer Center. There were 96 males and 83 females with a median age of 64 years (range 17-97) and elderly subsets more than 70 (n = 53) and more than 80 (n = 18) years of age. Diagnoses included gastric cancer (n = 83, 46%), pancreatic or periampullary cancer (n = 78, 44%), and benign pancreatic (n = 11, 6%) or gastric (n = 7, 4%) conditions. Age >70 years was correlated with more complex underlying medical conditions (P = 0.001) and gastrectomy for cancer (P = 0.01). None of four in-hospital deaths or 11 90-day lethal events occurred in patients >70 years of age (P = 0.005). Overall complications (35% vs 49%) and major complications (25% vs 37%) were less frequent in the older patient group [P = not significant (NS)]. Median intensive care unit stay (3 vs 2 days) and hospital stay (12 vs 12.5 days) were similar (P = NS). Pancreatoduodenectomy, gastrectomy for "benign" indications, and splenectomy--but not age--were significant prognostic variables for increased complications and longer hospital stay (at P < 0.05). At a median follow-up of 13 months (20 for survivors) the median survival after resection for gastric cancer (30 vs 16 months) or pancreatic/periampullary cancer (30 vs 23 months) was not inferior in elderly patients (P = NS). Five-year disease-free survival was superior in gastric cancer patients >70 years (59% vs 26%, P = 0.03) but not for pancreatic cancer. Advanced age under current clinical selection criteria does not impose increased hazards beyond disease- and procedure-related risk factors for patients undergoing gastrectom...
ACCESSION #
5738863

 

Related Articles

  • Laparoscopic gastrectomy for gastric cancer: early experience among the elderly. Singh, K. K.; Rohatgi, A.; Rybinkina, Iryna; McCulloch, Peter; Mudan, Satvinder // Surgical Endoscopy;Apr2008, Vol. 22 Issue 4, p1002 

    The data are scarce on the outcome for elderly patients presenting with resectable gastric cancer in the West who have been treated with minimally invasive surgery. This report presents the authors’ early experience with totally laparoscopic gastric resections for cancer in elderly...

  • Post-operative abdominal drainage following major upper gastrointestinal surgery: Single drain versus two drains. Shrikhande, Shailesh V.; Barreto, Savio G.; Shetty, Guruprasad; Suradkar, Kunal; Bodhankar, Yashodhan D.; Shah, Sumeet B.; Goel, Mahesh // Journal of Cancer Research & Therapeutics;Apr-Jun2013, Vol. 9 Issue 2, p267 

    Background: Traditionally, surgeons have resorted to placing drains following major gastrointestinal surgery. In recent years, the value of routine drainage has been questioned, especially in the light of their role in post-operative pain, infection, and prolonged hospital stay. The aim of this...

  • Outcome of D2 Gastrectomy with Combined Resection of Invaded Adjacent Organs in Patients with T4 Gastric Carcinoma: 10-Year Experience. Euanorasetr, Chakrapan // Thai Journal of Surgery;Apr-Jun2006, Vol. 27 Issue 2, p49 

    Background: The surgical management of locally advanced gastric carcinoma with invasion to adjacent organs (T4) remains controversial and many still question the benefit of a combined resection with D2 gastrectomy. Objectives: The aim of this study was to examine the morbidity and mortality...

  • Palliative Resection in Noncurative Gastric Cancer Patients. Kuo-Hung Huang; Chew-Wun Wu; Wen-Liang Fang; Jen-Hao Chen; Su-Shun Lo; Ruei-Fang Wang; Anna Fen-Yau Li // World Journal of Surgery;May2010, Vol. 34 Issue 5, p1015 

    Palliative resection for noncurable gastric cancer remains controversial, especially in the elderly. This retrospective study was designed to elucidate the clinicopathological factors and operative outcome in patients undergoing palliative gastric resection. From January 1988 to December 2008,...

  • Survival benefit of non-curative gastrectomy for gastric cancer patients with synchronous distant metastasis. Chen Li; Min Yan; Jun Chen; Min Xiang; Zheng Gang Zhu; Hao Ran Yin; Yan Zheng Lin; Li, Chen; Yan, Min; Chen, Jun; Xiang, Min; Zhu, Zheng Gang; Yin, Hao Ran; Lin, Yan Zheng // Journal of Gastrointestinal Surgery;Feb2010, Vol. 14 Issue 2, p282 

    Background: The prognosis for gastric cancer patients with distant metastasis is very poor. The purpose of this study was to evaluate the survival benefit of non-curative gastrectomy for gastric cancer patients with synchronous distant metastasis.Methods: From 1992 to...

  • Extended Lymphadenectomy in Gastric Cancer Is Crucial. Ferri, Lorenzo // World Journal of Surgery;Aug2013, Vol. 37 Issue 8, p1768 

    The article discusses the significance of using extended lymphadenectomy in treating gastric cancer. It outlines the benefits of extended lymphadenectomy, including local or regional control, staging and overall patient survival, for solid malignancies. It evaluates the effectiveness of extended...

  • Surgery for gastric cancer: An evidence-based perspective. D'souza, Melroy A.; Singh, Kailash; Shrikhande, Shailesh V. // Journal of Cancer Research & Therapeutics;Oct-Dec2009, Vol. 5 Issue 4, p225 

    Despite a decreasing incidence, stomach cancer is the second leading cause of cancer mortality worldwide. Surgical resection offers the only chance for cure in this aggressive cancer. The surgical management of gastric cancer has witnessed numerous debates in the past decades. These include the...

  • Best practice in macroscopic examination of gastric resections. Pritchard, S. A. // Journal of Clinical Pathology;Feb2008, Vol. 61 Issue 2, p172 

    Gastric cancer is one of the most common cancers worldwide, with a frequency that varies greatly across different geographic locations. Over recent decades there has been a marked increase in cancers of the oesophagogastric junction, but gastric cancers have shown a decrease in worldwide...

  • Laparoscopic surgery for submucosal tumors located at the esophagogastric junction and the prepylorus. Sun-Hwi Hwang; Do Joong Park; Young Hoong Kim; Kyoung Ho Lee; Hye Seung Lee; Hyung-Ho Kim; Hyuk-Joon Lee; Han-Kwang Yang; Kuhn Uk Lee // Surgical Endoscopy;Sep2009, Vol. 23 Issue 9, p1980 

    Laparoscopic partial gastric resection is widely accepted as a treatment for gastric submucosal tumors (SMTs). However, SMTs of either end of the stomach are generally managed by subtotal gastrectomies or total gastrectomies. This study was conducted to evaluate surgical techniques for...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics