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Major Gastrointestinal Cancer Resections in the Elderly in India: Poised for Future Challenges
Swati Batra1, Kunal Suradkar, Sanjay Talole
1Department of GI and HPB Surgical Oncology, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai, India.
Background:
There are no data on surgical outcomes of major gastrointestinal cancer resections in the expanding Indian oncogeriatric population.
Methods:
A prospective database of patients who underwent major gastrointestinal cancer resections during varying time periods (2006-2014) was analyzed retrospectively.
Results:
Two thousand six hundred and forty three patients with a median age of 53 were analyzed. Four hundred and seventy two (17.9%) patients were aged ≥65 years and 235 (8.9%) patients were ≥70 years. Mortality rates were not significantly higher in the elderly (≥65 years) or the very elderly (≥70 years) when compared to younger controls, being 2.8 vs. 1.6% (p = 0.09) and 3.0 vs. 1.7% (p = 0.162) respectively. Overall morbidity was similar for patients ≥65 or <65 years (24.2 vs. 21.7%, p = 0.253), but was higher in patients ≥70 years (29.8 vs. 21.4%, p = 0.003). The incidence of severe complications, however, was not significantly greater in this age group (13.2 vs. 12.5%, p = 0.74).
Conclusions:
Major gastrointestinal cancer resections in the elderly Indian population, though uncommon, are safe when performed at experienced high volume centres. These results should serve as a starting point for the gradual development of dedicated oncogeriatric programs in the Indian subcontinent.
