Malignancy in nonagenarians

In a series of 143 necropsies on aged subjects, age range 90 to 100, 20 patients were found to have died of malignant disease and a further 16 patients had a total of 20 non-fatal malignant tumours. The rate of clinical recognition was lower than would be expected in other age groups. Adenocarcinomas of the digestive system predominated in the fatal group. This study confirms previous reports of a high incidence of non-fatal tumours and a diminished tendency to metastasis in both fatal and non-fatal cases. These features are not thought to imply diminished aggressiveness of malignant tumours in extreme old age, since analysis of individual cases provided other explanations such as death from unrecognised local complications of the tumour or the intervention of an unrelated cause of death. There was, however, an unexpectedly high number of cases of long survival after excision of a malignant tumour, including a case of spontaneous regression.