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Outcome of surgical treatment of colorectal cancer in the elderly

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Abstract

The aim of this study is to compare the clinical features and the perioperative and long-term outcomes after primary surgery for colorectal cancer (CRC) in the elderly population with those observed in younger patients. All the patients over the age of 55 who underwent primary surgery for CRC in our clinic from 1988 to 2008 were included in this study and divided into two age groups: 55–75 and >75 years considering the age of diagnosis. 914 consecutive patients were enrolled in the study (352 > 75 years). In the elderly group, tumors were predominantly right sided, and the overall number of comorbidities was statistical more frequent. Elderly patients underwent emergency surgery more than the control group (p = 0.0008). There were no significant differences between the two groups in terms of curative and palliative resections. The overall operative mortality rate was 5.9% in the study group compared with 2.1% in the control study (p = 0.0033). The overall 3-year, 5-year and 10-year survival rates were, respectively, 37, 16.2 and 5.1% in the study group, when compared with 52.3, 35.1 and 24.7% in the control group (p = 0.022, p = 0.0001 and p = 0.0001, respectively). More patients were lost during the follow-up in the elderly group (p = 0.0003) and more deaths unrelated to cancer were found in the study group compared with the control group (p = 0.0005). The cancer specific mortality was similar between the two groups. In conclusion, elderly patients that underwent major colorectal resection have an acceptable perioperative morbidity, mortality and survival rate when compared with younger patients. Age alone should not be considered a reason to deny surgery to these patients.

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References

  1. Spivak H, Vande Maele D, Friedman I, Nussbaum M (1996) Colorectal surgery in octuagenarians. J Am Coll Surg 183:46–50

    PubMed  CAS  Google Scholar 

  2. Hosking MP, Warner MA, Lobdell CM, Offord KP, Melton LJ (1989) Outcomes of surgery in patients 90 years of age and older. JAMA 261:1909–1915

    Article  PubMed  CAS  Google Scholar 

  3. Houry S, Amenabar J, Rezvani A, Huguier M (1994) Should patients over 80 years old be operated on for colorectal or gastric cancer? Hepatogastroenterology 41:521–525

    PubMed  CAS  Google Scholar 

  4. Goodwin JS, Samet JM, Hunt WC (1996) Determinants of survival in older cancer patients. J Natl Cancer Inst 88:1031–1038

    Article  PubMed  CAS  Google Scholar 

  5. Owens WD, Felts JA, Spitznaegel EL (1978) ASA physical status classifications. A study of consistency ratings. Anesthesiology 49:239–243

    Article  PubMed  CAS  Google Scholar 

  6. Basili G, Lorenzetti L, Biondi G et al (2008) Colorectal cancer in the elderly. Is there a role for safe and curative surgery? ANZ J Surg 78:466–470

    Article  PubMed  Google Scholar 

  7. Devon KM, Vergara-Fernandez O, Victor JC et al (2009) Colorectal cancer surgery in elderly patients: presentation, treatment, and outcomes. Dis Colon Rectum 52:1272–1277

    Article  PubMed  CAS  Google Scholar 

  8. Latkauskas T, Rudinskaite G, Kurtinaitis J et al (2005) The impact of age on post-operative outcomes of colorectal cancer patients undergoing surgical treatment. BMC Cancer 5:153–158

    Article  PubMed  Google Scholar 

  9. Vironen JH, Sainio P, Husa AI et al (2004) Complications and survival after surgery for rectal cancer in patients younger than aged 75 years or older. Dis Colon Rectum 47:1225–1231

    Article  PubMed  Google Scholar 

  10. Hessman O, Bergkvist L, Strom S et al (1997) Colorectal cancer in patients over 75 years old. Determinants of outcome. Eur J Surg Oncol 23:13–19

    Article  PubMed  CAS  Google Scholar 

  11. Puig-La Calle J Jr, Quayle J, Quayle HT et al (2000) Favorable short-term and long-term outcome after elective radical rectal cancer resection in patients 75 years of age or older. Dis Colon Rectum 43:1704–1709

    Article  PubMed  Google Scholar 

  12. Damhuis RA, Wereldsma JC, Wiggers T (1996) The influence of age on resection rates and postoperative mortality in 6457 patients with colorectal cancer. Int J Colorectal Dis 11:45–48

    PubMed  CAS  Google Scholar 

  13. Barrier A, Ferro L, Houry S et al (2003) Rectal cancer surgery in patients more than 80 years of age. Am J Surg 185:54–57

    Article  PubMed  Google Scholar 

  14. Gurevitch AJ, Davidovitch B, Kashtan H (2009) Outcome of right colectomy for cancer in octogenarians. J Gastrointest Surg 13:100–104

    Article  PubMed  Google Scholar 

  15. Tan KY, Chen CM, Ng C, Tan SM, Tay KH (2006) Which octogenarians do poorly after major open abdominal surgery in our Asian population? World J Surg 30:547–552

    Article  PubMed  Google Scholar 

  16. Ong ES, Alassas M, Dunn KB, Rajput A (2008) Colorectal cancer surgery in the elderly: acceptable morbidity? Am J Surg 195:344–348

    Article  PubMed  Google Scholar 

  17. Irvin TT (1988) Prognosis of colorectal cancer in the elderly. Br J Surg 75:419–421

    Article  PubMed  CAS  Google Scholar 

  18. Greenburg AG, Saik RP, Pridham D (1985) Influence of age on mortality of colon surgery. Am J Surg 150:65–70

    Article  PubMed  CAS  Google Scholar 

  19. Colorectal Cancer Collaborative Group (2000) Surgery for colorectal cancer in elderly patients a systematic review. Lancet 356:968–974

    Article  Google Scholar 

  20. Marusch F, Koch A, Schmidt U, Steinert R, Ueberrueck T, Bittner R, Berg E, Engemann R, Gellert K, Arbogast R, Körner T, Köckerling F, Gastinger I, Lippert H (2005) Working Group Colon/Rectum Cancer. 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 29:1013–1021

    Article  PubMed  Google Scholar 

  21. Basdanis G, Papadopoulos VN, Michalopoulos A, Fahantidis E, Apostolidis S, Berovalis P, Zatagias A, Karamanlis E (2004) Colorectal cancer in patients over 70 years of age: determinants of outcome. Tech Coloproctol 8(Suppl 1):S112–S115

    Article  PubMed  Google Scholar 

  22. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Nakajima H, Asao T, Kuwano H (2004) Should patients over 85 years old be operated on for colorectal cancer? J Clin Gastroenterol 38:408–413

    Article  PubMed  Google Scholar 

  23. Edna TH, Bjerkeset T (1998) Colorectal cancer in patients over 80 years of age. Hepatogastroenterology 45:2142–2145

    PubMed  CAS  Google Scholar 

  24. Violi V, Pietra N, Grattarola M et al (1998) Curative surgery for colorectal cancer: long-term results and life expectancy in the elderly. Dis Colon Rectum 41:291–298

    Article  PubMed  CAS  Google Scholar 

  25. Arnaud JP, Schloegel M, Ollier JC, Adloff M (1991) Colorectal cancer in patients over 80 years of age. Dis Colon Rectum 34:896–898

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Jacopo Martellucci.

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Fontani, A., Martellucci, J., Civitelli, S. et al. Outcome of surgical treatment of colorectal cancer in the elderly. Updates Surg 63, 233–237 (2011). https://doi.org/10.1007/s13304-011-0085-4

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