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Colorectal cancer surgery in octogenarians: real-world long-term results

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Abstract

Aims

Colon cancer is the most common intra-abdominal cancer in older people. In the elderly with cancer, clinical decision making is often complicated by the effects of aging. However, as life expectancy continues to rise, more people aged 80 and older will present with colorectal cancer and may need major surgery.

Methods

Between 2000 and 2020 we operated on 352 patients aged 80 and older for colorectal cancer. We reviewed the case-notes of these patients and made a survival analysis for those patients who had a surgical resection of the tumor.

Results

In 20 patients a palliative procedure was performed. Three hundred and thirty-two (332) patients had a colorectal cancer resected. Of these, 57 patients died within 90 days postoperatively. Survival analysis was done for 275 patients who were alive longer than 90 days postoperatively. The overall 5-year survival in this group is 41.5%. There was no significant difference in postoperative survival between patients over the age of 85 and patients aged 80–84 at the time of operation. The survival of patients with stage IV colorectal adenocarcinoma is significantly worse than survival in stage I–III patients (Cox-Mantel log-rank test p < 0.001).

Conclusions

After exclusion of the patients in the 90-day mortality group the overall 5-year survival in octogenarians who had a resection of a colorectal cancer was 41.5%. The most difficult problem is to choose the right treatment for the right patient. Optimal surgical and adjuvant treatment should not be denied to these older patients.

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Data Availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

Authors

Contributions

P.W wrote the main manuscript text and prepared the figures

P.W. and S.P. did the statistical analysis

P.W., S.D and S.H. did perform/ were involved in the surgical procedures

P.W., FvF and S.P. were involved in the follow-up of the patients

All authors reviewed the manuscript.

Corresponding author

Correspondence to Paul Willemsen.

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Competing interests

The authors declare no competing interests.

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This study was presented as a poster at ESSO 41, Bordeaux, France 19–22 0ctober 2022.

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Willemsen, P., Devriendt, S., Heyman, S. et al. Colorectal cancer surgery in octogenarians: real-world long-term results. Langenbecks Arch Surg 409, 13 (2024). https://doi.org/10.1007/s00423-023-03201-y

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