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Gastroenterologie 21. Dezember 2015

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

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.

A. Dinnewitzer, C. Nawara, C. Augschöll, D. Neureiter, W. Hitzl, D. Öfner, T. Jäger, European Surgery 6/2015

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