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. 2023 Nov 29:13:1268190.
doi: 10.3389/fonc.2023.1268190. eCollection 2023.

Surgical oncological emergencies in octogenarian patients

Alberto Friziero  1 , Cosimo Sperti  2 , Federica Riccio  1 , Irene Sole Zuin  1 , Lorenzo Vallese  1 , Simone Serafini  1 , Alessandra Amico  1 , Valeria Valli  1 , Chiara Da Re  1 , Nicola Baldan  1 , Michele Valmasoni  1 , Gianfranco Da Dalt  1
Affiliations

Surgical oncological emergencies in octogenarian patients

Alberto Friziero et al. Front Oncol. .

Abstract

Background: Surgical oncological emergencies represent a frequent challenge in acute settings, with postoperative courses characterized by high morbidity and mortality. An accurate selection of patients who could benefit from surgery is essential to avoid unnecessary invasive treatment. In this study, we tried to determine if advanced age (>80 years) represents a risk factor for negative short-term outcome in patients undergoing emergency surgery for acute abdominal oncological illness.

Methods: We retrospectively analyzed the records of patients who underwent emergency oncological surgery at the Department of Acute Care Surgery of Padua General Hospital from January 2018 to December 2022. One hundred two cancer patients were included in the study. Among them, 42 were aged ≥80 years (41%). Multiple preoperative and postoperative parameters were recorded, and the follow-up period was at least 90 days. Multivariate logistic regression analyses were used to identify factors associated with short-term postoperative outcomes.

Results: In the octogenarian group, 30-day mortality was 11% vs. 9.5% in the younger group [p = not significant (ns)] and 90-day mortality was 17.6% in the octogenarian group vs. 20.5% in the younger group (p = ns). Postoperative morbidity and hospital length of stay were not significantly different in the two groups. Low albumin levels [odds ratio (OR) 30.6, 9.51-87.07] and elevated lactate dehydrogenase (LDH) levels (OR 26.4, 9.18-75.83) were predictive for short-term mortality in surgical oncological emergencies.

Conclusion: Advanced age is not a risk factor for negative outcomes in surgical oncological emergencies. Therefore, surgical options should be considered in octogenarians with oncological emergencies and acceptable clinical conditions. Serum albumin levels and LDH can help predict the postoperative outcome after surgery for oncological emergencies.

Keywords: age; colectomy; colon cancer; emergency; octogenarians; surgical oncology.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor LS declared a past co-authorship with the authors AF, CS, and SS.

Figures

Figure 1
Figure 1
Distribution of the population.
Figure 2
Figure 2
Overall actuarial survival curves comparing patients under 80 years to patients aged >80 years.
Figure 3
Figure 3
Receiver operator characteristic (ROC) curves of serum albumin levels.
Figure 4
Figure 4
Receiver operator characteristic (ROC) curves of serum LDH levels.
See this image and copyright information in PMC

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