Abstract
Abstract
Background
Although functional outcomes are important in surgery for elderly patients, the long-term functional prognosis following oncologic surgery is unclear. We retrospectively investigated the long-term, functional and survival prognosis following major oncologic surgery according to age among elderly patients.
Methods
We used a Japanese administrative database to identify 11,896 patients aged ≥ 65 years who underwent major oncological surgery between June 2014 and February 2019. We investigated the association between age at surgery and the postoperative incidence of bedridden status and mortality. Using the Fine–Gray model and restricted cubic spline functions, we conducted a multivariable, survival analysis with adjustments for patient background characteristics and treatment courses to estimate hazard ratios for the outcomes.
Results
During a median follow-up of 588 (interquartile range, 267–997) days, 657 patients (5.5%) became bedridden and 1540 (13%) died. Patients aged ≥ 70 years had a significantly higher incidence of being bedridden than those aged 65–69 years; the subdistribution hazard ratios of the age groups of 70–74, 75–79, 80–84, and ≥ 85 years were 3.20 (95% confidence interval [CI], 1.53–6.71), 3.86 (95% CI 1.89–7.89), 6.26 (95% CI 3.06–12.8), and 8.60 (95% CI 4.19–17.7), respectively. Restricted cubic spline analysis demonstrated an increase in the incidence of bedridden status in patients aged ≥ 65 years, whereas mortality increased in patients aged ≥ 75 years.
Conclusions
This large-scale, observational study revealed that older age at oncological surgery was associated with poorer functional outcomes and higher mortality among patients aged ≥ 65 years.
Funder
Ministry of Health, Labour and Welfare
Ministry of Education, Culture, Sports, Science and Technology
The University of Tokyo
Publisher
Springer Science and Business Media LLC
Cited by
1 articles.
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