Scientific paper
Rectal cancer surgery in patients more than 80 years of age

https://doi.org/10.1016/S0002-9610(02)01120-0Get rights and content

Abstract

Background

This retrospective study aimed to compare the prognosis for rectal cancer in patients more than 80 years old with that observed in younger patients.

Methods

Patients operated on for a rectal adenocarcinoma, from 1980 to 1998, were divided into two groups: group 1 (>80 years, n = 92); group 2 (<80 years, n = 276).

Results

There were significant differences between the two groups with regard to the sex ratio, the American Society of Anesthesiologists (ASA) classification, the emergency presentation, and the curative operation rate. The operative mortality rate was 8% in group 1, 4% in group 2 (P = 0.26). The overall 5-year survival rate was 35% in group 1, 53% in group 2 (P = 0.0004). In patients operated on for cure, the cancer-specific 5-year survival rate was 50% in group 1, 59% in group 2 (P = 0.08).

Conclusions

The prognosis for rectal cancer in patients over 80 years is not significantly different from that of younger patients. Surgery should not be restricted on the basis of age.

Section snippets

Patients and methods

From 1980 to 1998, 368 patients were operated on for adenocarcinoma of the rectum in our institution. For the purpose of the study, they were divided into two groups: group 1 included 92 patients (25%) who were 80 years of age or older on first presentation (age range 80 to 91 years; mean age 83.3 years); group 2 included 276 patients (75%) who were younger than 80 years (age range 15 to 79 years; mean age 62.6 years).

The collected data included the sex and operative risk factors (according to

Results

Characteristics of patients and tumors are given in Table 1. There were significant differences with regard to the sex-ratio and the operative risk of patients: among patients over 80 years of age (group 1), 41% were male compared with 59% in patients under 80 years (group 2; chi-square = 8.41, 1 d.f., P = 0.004); 33% of patients were classified as ASA III/IV in group 1 compared with 16% in group 2 (chi-square = 11.32, 1 d.f., P < 0.001). There was no significant difference between the two

Comments

Previous studies about colorectal cancer surgery in the elderly were performed in patients older than 70 [5], [10], 75 [4], [13], 80 [6], [8], [9], [14], [15], [16], [17], or 90 years of age [18]. In the present study, limited to rectal cancer surgery, 80 years was selected as a limit of age for two reasons. Firstly, patients over 80 years of age represent more than 20% of patients [6], [14], this rate being verified in our series. Secondly, some studies have suggested that 80 years represents

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