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Morbidity, mortality, and survival in elderly patients undergoing pulmonary metastasectomy for colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The number of elderly patients with colorectal cancer is increasing. Nevertheless, they are undertreated compared to younger patients. This study compares postoperative morbidity, mortality, survival, and morbidity risk factors of elderly and younger patients undergoing pulmonary metastasectomy (PM).

Methods

We retrospectively analyzed our prospective database of 224 patients operated for colorectal lung metastases between 1999 and 2014. Two groups were defined to evaluate the influence of the patients’ age (A: < 70 years; B: ≥ 70 years). Morbidity, mortality, and risk factors for morbidity were analyzed using χ2-test and Fisher’s exact test. The Kaplan–Meier method, log–rank test, and multivariate Cox regression were used to assess survival and prognosticators.

Results

Altogether, minor morbidity, major morbidity, and mortality were 17%, 5.8%, and 0%, respectively. Between groups A (n = 170) and B (n = 54), there was no difference in minor and major morbidity (p = 0.100) or mortality (0%). Heart arrhythmia was a risk factor for increased morbidity in group B (p = 0.007). The 5-, 10-, and 15-year survival rates were 43%, 30%, and 27%, respectively, in group A and 55%, 36 and 19%, respectively, in group B (p = 0.316). Disease-free interval ≥ 36 months (p = 0.023; OR 2.88) and anatomic resections (p = 0.022; OR 3.05) were associated with prolonged survival in elderly patients.

Conclusions

Morbidity, mortality, and overall survival after PM with lymphadenectomy for elderly patients were comparable to younger patients. A disease-free interval > 36 months and anatomic lung resections might be associated with prolonged survival. However, elderly patients should also be evaluated for a curative treatment.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Germany

    S. Sponholz, Moritz Schirren, Selma Oguzhan & Joachim Schirren

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  1. S. Sponholz
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  2. Moritz Schirren
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  3. Selma Oguzhan
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  4. Joachim Schirren
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Correspondence to S. Sponholz.

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The authors declare that they are no financial relationship, conflict of interests, or funding sources.

“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.”

“For this type of study formal consent is not required.”

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Sponholz, S., Schirren, M., Oguzhan, S. et al. Morbidity, mortality, and survival in elderly patients undergoing pulmonary metastasectomy for colorectal cancer. Int J Colorectal Dis 33, 1401–1409 (2018). https://doi.org/10.1007/s00384-018-3136-1

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