World Journal of Surgery

, Volume 29, Issue 8, pp 1013–1021

The Impact of the Risk Factor “Age” on the Early Postoperative Results of Surgery for Colorectal Carcinoma and Its Significance for Perioperative Management

  • Frank Marusch
  • Andreas Koch
  • Uwe Schmidt
  • Ralf Steinert
  • Torsten Ueberrueck
  • Reinhard Bittner
  • Eugen Berg
  • Rainer Engemann
  • Klaus Gellert
  • Rainer Arbogast
  • Thomas Körner
  • Ferdinand Köckerling
  • Ingo Gastinger
  • Hans Lippert
Original article

DOI: 10.1007/s00268-005-7711-6

Cite this article as:
Marusch, F., Koch, A., Schmidt, U. et al. World J. Surg. (2005) 29: 1013. doi:10.1007/s00268-005-7711-6

Abstract

The risks and benefits of surgery for colorectal cancer in old patients have not been unequivocally defined. The present investigation was carried out in 309 hospitals as a prospective multicenter study. In the period between 1 January 2000 and 31 December 2001, a total of 19,080 patients were recruited for the study; 16,142 (84.6%) patients were younger than 80 years (<80) and 2932 (15.4%) were 80 years and older (≥ 80). Significant differences between the age groups were observed for general postoperative complications (22.3% for <80 years; 33.9% for ≥ 80). Specific postoperative complications were identical in both groups. Overall, significantly elevated morbidity and mortality rates were found with increasing age (morbidity: 33.9% vs. 43.5%; mortality: 2.6% vs. 8.0%). The distribution of tumor stages revealed a significantly higher percentage of locally advanced tumors in the older age group (stage II: 28.0% vs. 34.4%). In contrast, no increase in metastasizing tumors was found in the older age group (stage IV: 17.4% vs. 14.1%). Logistic regression showed that, in concert with a number of other parameters, age is a significant influencing factor on postoperative morbidity and mortality. The increase in postoperative morbidity and mortality rates associated with aging is a result of the increase in general postoperative complications, in particular, pneumonia and cardiovascular complications. Age as such does not represent a contraindication for surgical treatment. The short-term outcome and quality of life are of overriding importance for the geriatric patient.

Copyright information

© Société Internationale de Chirurgie 2005

Authors and Affiliations

  • Frank Marusch
    • 1
    • 9
  • Andreas Koch
    • 1
    • 9
  • Uwe Schmidt
    • 1
  • Ralf Steinert
    • 1
    • 9
  • Torsten Ueberrueck
    • 1
    • 9
  • Reinhard Bittner
    • 2
  • Eugen Berg
    • 3
  • Rainer Engemann
    • 4
  • Klaus Gellert
    • 5
  • Rainer Arbogast
    • 6
  • Thomas Körner
    • 8
  • Ferdinand Köckerling
    • 1
    • 8
  • Ingo Gastinger
    • 1
    • 9
  • Hans Lippert
    • 1
    • 10
  1. 1.Institute for Quality Management in Operative MedicineOtto-von-Guericke University MagdeburgMagdeburgGermany
  2. 2.Department of SurgeryMarien-Hospital StuttgartStuttgartGermany
  3. 3.Department of ColoproctologyProsper-Hospital RecklinghausenRecklinghausenGermany
  4. 4.Department of SurgeryAschaffenburg HospitalAschaffenburgGermany
  5. 5.Department of SurgeryOscar-Ziethen-Hospital, Berlin-LichtenbergBerlinGermany
  6. 6.Department of SurgeryPforzheim HospitalPforzheimGermany
  7. 7.Department of GastroenterologySuhl HospitalSuhlGermany
  8. 8.Department of SurgeryHanover-HospitalHanoverGermany
  9. 9.Department of SurgeryCarl-Thiem Hospital CottbusCottbusGermany
  10. 10.Department of SurgeryOtto-von-Guericke University MagdeburgMagdeburgGermany