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Poor Results from Octogenarian Cancer Surgery

Population-based data paints a more realistic- and less positive- picture than case data

THURSDAY, Dec. 27 (HealthDay News) -- Population-based data show that high-risk cancer surgery on octogenarians has worse outcomes than previously reported case series and survival statistics indicate, researchers report in the December issue of the Journal of the American College of Surgeons.

Emily Finlayson, M.D., and colleagues at the University of Michigan in Ann Arbor, conducted a study of 272,662 patients using data from the 1994 to 2003 Nationwide Inpatient Sample to compare operative mortality and discharge disposition of patients aged 65 to 69 years and octogenarians who underwent surgery for lung, esophageal and pancreatic cancer.

In terms of operative mortality, the outcome for octogenarians was far worse than their younger counterparts: 19.9 percent versus 8.8 percent for esophagectomy, 15.5 percent versus 6.7 percent for pancreatectomy, and 6.9 percent versus 3.7 percent for lung resection. Octogenarians' five-year survival after pancreatectomy, esophagectomy and lung cancer resection was 11 percent, 18 percent and 31 percent, respectively, and was even lower for those with two or more comorbidities.

"Population-based outcomes after high-risk cancer operation in octogenarians are considerably worse than typically reported in case series and published survival statistics. Such information might better inform clinical decision making in this high-risk group," the authors conclude.

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