Postoperative mortality after cancer surgery in octogenarians and nonagenarians: results from a series of 5,390 patients
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Postoperative mortality after cancer surgery in octogenarians and nonagenarians: results from a series of 5,390 patients Ronald AM Damhuis*1, Claudia JC Meurs1 and Willem S Meijer2 Address: 1Rotterdam Cancer Registry, Rotterdam, The Netherlands and 2Medical Center Rijnmond-Zuid, Department of Surgery, P.O. Box 9119, 3007 AC Rotterdam, The Netherlands Email: Ronald AM Damhuis* - [email protected]; Claudia JC Meurs - [email protected]; Willem S Meijer - [email protected] * Corresponding author
Published: 09 November 2005 World Journal of Surgical Oncology 2005, 3:71
doi:10.1186/1477-7819-3-71
Received: 19 August 2005 Accepted: 09 November 2005
This article is available from: http://www.wjso.com/content/3/1/71 © 2005 Damhuis et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: To support decisions about surgical treatment of elderly patients with cancer, population-based estimates of postoperative mortality (POM) rates are required. Methods: Electronic records from the Rotterdam Cancer Registry were retrieved for octogenarians and nonagenarians who underwent resection in the period 1987–2000. POM was defined as death within 30 days of resection and both elective and emergency operations were included. Results: In a series of 5.390 operated patients aged 80 years and older, POM rates were 0.5% for breast cancer, 1.7% for endometrial cancer and 4.2% for renal cancer. For patients with colorectal cancer, POM increased from 8% for the age group 80–84 to 13% for those 85–89 to 20% in nonagenarians. For stomach cancer, the respective figures were 11%, 20% and 44%. Conclusion: These results show that resections can be performed at acceptable risk in selected elderly patients with cancer.
Background As a result of ageing of the general population, the proportion of elderly patients with cancer is increasing within Europe. In the Netherlands, 14% of male patients and 17% of female patients are 80 years or older at diagnosis [1]. In the elderly, relative survival is generally worse than in younger patients [2], mainly due to a more advanced stage at diagnosis or due to less extensive treatment. Especially surgery is withheld out of concern for postoperative morbidity and mortality. Many studies, however, suggest that surgical treatment can be performed at acceptable risk and with good results. These reports usually come from specialized centres with selected series and may be too optimistic due to reporting and publication bias. To sup-
port decisions about the option of surgical treatment in a general situation, we studied postoperative mortality rates using data from a population-based cancer registry.
Methods Information on octogenarians and nonagenarians who underwent resection for cancer in the period 1987–2000 was retr
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