Background: The aims of this retrospective study were to determine the factors predictive of morbidity and mortality, and to evaluate the probability of long-term survival in octogenarians with carcinomas of the gastrointestinal tract. Patients and Methods: Out of a total of 194 patients, aged 80 years or over, with histologically diagnosed carcinoma of the stomach or colon-rectum, observed between 1987 and 1995, 167 underwent surgery and were included in this study. The relationship between a series of clinico-pathological variables and morbidity/mortality rates was investigated by univariate and multivariate analysis. Complete follow-up data were available in 161 patients. Results: Fifty-nine patients (35.3%) experienced complications and 14 (8.4%) died during hospitalization. Statistical analysis identified hypoalbuminaemia (P < 0.01, relative risk (RR) = 2.92) and hypercreatininaemia (P < 0.05, RR = 3.59) as independent predictors of post-operative complications. Hypercreatininaemia (P < 0.05, RR = 5.22) and noncurative surgery (P < 0.05, RR = 3.99) significantly affected operative mortality. Crude 5-year survival rate, including operative mortality after curative surgery, was 41% in gastric cancer and 39% in colorectal cancer patients. Conclusion: These results indicate that surgery for gastrointestinal carcinomas yields an acceptable operative risk in octogenarians, and provides good long-term results if oncological radicality can be obtained. Pre-operative evaluation of tumour stage and patient's general condition is useful to identify subgroups of patients at high risk of surgical complications and mortality. © 2000 Harcourt Publishers Ltd. U.O. Chirurgia Oncologica, University of Siena, Italy. Abstract BACKGROUND: The aims of this retrospective study were to determine the factors predictive of morbidity and mortality, and to evaluate the probability of long-term survival in octogenarians with carcinomas of the gastrointestinal tract. PATIENTS AND METHODS: Out of a total of 194 patients, aged 80 years or over, with histologically diagnosed carcinoma of the stomach or colon-rectum, observed between 1987 and 1995, 167 underwent surgery and were included in this study. The relationship between a series of clinico-pathological variables and morbidity/mortality rates was investigated by univariate and multivariate analysis. Complete follow-up data were available in 161 patients. RESULTS: Fifty-nine patients (35.3%) experienced complications and 14 (8.4%) died during hospitalization. Statistical analysis identified hypoalbuminaemia (P<0.01, relative risk (RR)=2.92) and hypercreatininaemia (P<0.05, RR=3.59) as independent predictors of post-operative complications. Hypercreatininaemia (P<0.05, RR=5.22) and non-curative surgery (P<0. 05, RR=3.99) significantly affected operative mortality. Crude 5-year survival rate, including operative mortality after curative surgery, was 41% in gastric cancer and 39% in colorectal cancer patients. CONCLUSION: These results indicate that surgery for gastrointestinal carcinomas yields an acceptable operative risk in octogenarians, and provides good long-term results if oncological radicality can be obtained. Pre-operative evaluation of tumour stage and patient's general condition is useful to identify subgroups of patients at high risk of surgical complications and mortality

Marrelli, D., Roviello, F., DE STEFANO, A., Vuolo, G., Brandi, C., Lottini, M., et al. (2000). Surgical treatment of gastrointestinal carcinomas in octogenarians: risk factors for complications and long-term outcome. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY, 26(4), 371-376 [10.1053/ejso.1999.0901].

Surgical treatment of gastrointestinal carcinomas in octogenarians: risk factors for complications and long-term outcome

MARRELLI, D.;ROVIELLO, F.;DE STEFANO, A.;BRANDI, C.;PINTO, E.
2000-01-01

Abstract

Background: The aims of this retrospective study were to determine the factors predictive of morbidity and mortality, and to evaluate the probability of long-term survival in octogenarians with carcinomas of the gastrointestinal tract. Patients and Methods: Out of a total of 194 patients, aged 80 years or over, with histologically diagnosed carcinoma of the stomach or colon-rectum, observed between 1987 and 1995, 167 underwent surgery and were included in this study. The relationship between a series of clinico-pathological variables and morbidity/mortality rates was investigated by univariate and multivariate analysis. Complete follow-up data were available in 161 patients. Results: Fifty-nine patients (35.3%) experienced complications and 14 (8.4%) died during hospitalization. Statistical analysis identified hypoalbuminaemia (P < 0.01, relative risk (RR) = 2.92) and hypercreatininaemia (P < 0.05, RR = 3.59) as independent predictors of post-operative complications. Hypercreatininaemia (P < 0.05, RR = 5.22) and noncurative surgery (P < 0.05, RR = 3.99) significantly affected operative mortality. Crude 5-year survival rate, including operative mortality after curative surgery, was 41% in gastric cancer and 39% in colorectal cancer patients. Conclusion: These results indicate that surgery for gastrointestinal carcinomas yields an acceptable operative risk in octogenarians, and provides good long-term results if oncological radicality can be obtained. Pre-operative evaluation of tumour stage and patient's general condition is useful to identify subgroups of patients at high risk of surgical complications and mortality. © 2000 Harcourt Publishers Ltd. U.O. Chirurgia Oncologica, University of Siena, Italy. Abstract BACKGROUND: The aims of this retrospective study were to determine the factors predictive of morbidity and mortality, and to evaluate the probability of long-term survival in octogenarians with carcinomas of the gastrointestinal tract. PATIENTS AND METHODS: Out of a total of 194 patients, aged 80 years or over, with histologically diagnosed carcinoma of the stomach or colon-rectum, observed between 1987 and 1995, 167 underwent surgery and were included in this study. The relationship between a series of clinico-pathological variables and morbidity/mortality rates was investigated by univariate and multivariate analysis. Complete follow-up data were available in 161 patients. RESULTS: Fifty-nine patients (35.3%) experienced complications and 14 (8.4%) died during hospitalization. Statistical analysis identified hypoalbuminaemia (P<0.01, relative risk (RR)=2.92) and hypercreatininaemia (P<0.05, RR=3.59) as independent predictors of post-operative complications. Hypercreatininaemia (P<0.05, RR=5.22) and non-curative surgery (P<0. 05, RR=3.99) significantly affected operative mortality. Crude 5-year survival rate, including operative mortality after curative surgery, was 41% in gastric cancer and 39% in colorectal cancer patients. CONCLUSION: These results indicate that surgery for gastrointestinal carcinomas yields an acceptable operative risk in octogenarians, and provides good long-term results if oncological radicality can be obtained. Pre-operative evaluation of tumour stage and patient's general condition is useful to identify subgroups of patients at high risk of surgical complications and mortality
2000
Marrelli, D., Roviello, F., DE STEFANO, A., Vuolo, G., Brandi, C., Lottini, M., et al. (2000). Surgical treatment of gastrointestinal carcinomas in octogenarians: risk factors for complications and long-term outcome. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY, 26(4), 371-376 [10.1053/ejso.1999.0901].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/26970
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