The Challenge in Treating the Elderly Colorectal Cancer Patient
- Kirk A. Ludwig MD
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The population of the USA is aging and, by 2030, 19% of our population, or about 72.1 million, will be aged 65 years or older: more than twice their number in the year 2000.1 Treating the elderly colorectal cancer patient is becoming increasingly commonplace, and since surgery forms the basis of treatment, we find ourselves on the front line, maneuvering around the elderly patient’s comorbidities, trying to avoid early morbidity and mortality, while at the same time balancing respect for the geriatric patient’s concerns over quality-of-life issues and desire for reasonable short-term outcomes with the desire to achieve good long-term cancer control. The study by Dekker et al. adds to our understanding of what happens when we operate on elderly colorectal cancer patients.2 These data should help as we struggle with managing this disease in this patient population.
The primary conclusion put forth by the authors of this population-based study of colorectal cancer patients from the western
- Unites States Department of Health and Human Services, Administration on Aging. http://www.aoa.gov/AoARoot/Aging_Statistics/index.aspx.
- Dekker JWT, van den Broek CBM, Bastiaannet E, van de Geest LGM, Tollenaar RAEM, Liefers GJ. Importance of the first postoperative year in the prognosis of elderly colorectal cancer patients. Ann Surg Oncol. 2011. Doi:10.1245/s10434-011-1671-x.
- Kunitake H, Zingmond DS, Ryoo J, Ko CY. Caring for octogenarian and nonagenarian patients with colorectal cancer: what should our standards and expectations be? Dis Colon Rectum. 2010;53:735–43. CrossRef
- Greenblatt DY, Weber SM, O’Connor ES, LoConte NK, Liou J, Smith MA. Readmission after colectomy for cancer predicts one-year mortality. Ann Surg. 2010;251(4):659–69. CrossRef
- Colorectal Cancer Collaborative Group. Surgery for colorectal cancer in elderly patients: a systematic review. Lancet. 2000;356:968–74. CrossRef
- Marusch F, Koch A, Schmidt U, Steinert R, Ueberrueck T, Bittner R, Berg E, et al. The impact of the risk factor “age” on the early postoperative results of surgery for colorectal carcinoma and its significance for perioperative management. World J Surg. 2005;29(8):1013–22. CrossRef
- Kiran RP, El-Gazzaz GH, Vogel JD, Remzi FH. Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from the national surgical quality improvement program. J Am Coll Surg. 2010;211(2):232–8. CrossRef
- Robinson CN, Chen J, Balentine CJ, Sansgiry S, Marshall CL, Anaya DA, et al. Minimally invasive surgery is underutilized for colon cancer. Ann Surg Oncol. Published on line 07 January 2011. Doi:10.1245/s10434-010-1479-0.
- The Challenge in Treating the Elderly Colorectal Cancer Patient
Annals of Surgical Oncology
Volume 18, Issue 6 , pp 1520-1521
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- 1. Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, USA