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The impact of advanced age on short- and long-term results after surgery for colorectal cancer

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Summary

Background

Elderly patients with colorectal cancer are often seen as high-risk candidates for surgical treatment. This study was designed to characterize the outcomes of persons older than 80 years, compared with younger persons.

Methods

We investigated the short-term surgical outcome and long-term survival of octogenarians undergoing surgery for colorectal cancer in a retrospective analysis. All patients scheduled for surgical resection of colorectal adenocarcinoma at our institution from 2003 to 2010 were included.

Results

Our study included 699 patients, 126 (18 %) of whom were aged 80 years or older. Presentation with later stage disease was not seen more frequently in the octogenarians. Comorbidities showed a significant increase (p < 0.001) and more emergency operations had to be performed in the elderly (p = 0.015). The probability for postoperative complications was associated with advanced age (p = 0.009) and 1-year mortality was significantly higher in the octogenarians. Overall survival was shorter in octogenarians, but no difference was found in cancer-specific survival or time-to-recurrence, compared with patients under 80.

Conclusion

Surgery for colorectal cancer in the elderly is challenging due to preexisting comorbidities and an increased rate of emergency operations. Although the short-term outcome of octogenarians is worse compared to younger patients, the long-term oncological results remain satisfactory, leading to the assumption that advanced age alone should not be a contraindication for surgical therapy.

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Authors and Affiliations

  1. Department of Surgery, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria

    A. Dinnewitzer, C. Nawara, C. Augschöll, D. Öfner & T. Jäger

  2. Institute of Pathology, Paracelsus Medical University, Salzburg, Austria

    D. Neureiter

  3. Research Office, Biostatistics, Paracelsus Medical University, Salzburg, Austria

    W. Hitzl

  4. Department of Visceral-, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Innsbruck, Austria

    D. Öfner

Authors
  1. A. Dinnewitzer
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  2. C. Nawara
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  3. C. Augschöll
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  4. D. Neureiter
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  5. W. Hitzl
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  6. D. Öfner
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  7. T. Jäger
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Correspondence to A. Dinnewitzer.

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Dinnewitzer, A., Nawara, C., Augschöll, C. et al. The impact of advanced age on short- and long-term results after surgery for colorectal cancer. Eur Surg 47, 331–336 (2015). https://doi.org/10.1007/s10353-015-0355-3

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  • DOI: https://doi.org/10.1007/s10353-015-0355-3

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