Major colorectal cancer resection should not be denied to the elderly

doi:10.1053/ejso.2002.1265

European Journal of Surgical Oncology (EJSO)

Volume 28, Issue 6, September 2002, Pages 661-666

https://doi.org/10.1053/ejso.2002.1265 Get rights and content

Abstract

Aims: Adjuvant therapy after surgery for colorectal cancer is often denied to the elderly for various reasons. This study was to determine morbidity and mortality risk after surgery in the elderly and whether this is affected by adjuvant therapy.

Methods: Data were collected prospectively and entered on a database for all patients undergoing resection of colorectal cancer between January 1994 and July 2000. A total of 304 patients were included, 65 aged 80 years and over.

Results: There were 84 deaths, 21 (30%) in the over 80s, and 63 (26%) in the under 80s (P=0.51). The ‘in-hospital’ mortality was 10.1% in the over 80s and 3.8% in the under 80s (P=0.056). In the over 80s the colon was more affected than the rectum (P=0.002). The over 80s were less likely to be offered adjuvant therapy, 7.2% vs 42.1% (P<0.001). The 5 year survival (all-cause mortality) in the over 80s was 58.5% and 47.6% in the under 80s (P=0.25). Cox's regression analysis of all patients identified the following factors to be independently related to overall survival: age > 80 years, post-operative leak, increasing Dukes stage and distant recurrence of disease.

Conclusion: This study has demonstrated that surgery should not be denied to elderly patients with colorectal cancer as despite a higher post-operative morbidity and mortality rate and with the absence of adjuvant therapy, favourable long-term outcome can be achieved by resectional surgery alone.

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^☆: Data from this manuscript have been presented at the European Conference on Cancer Strategies and Outcomes, Edinburgh, March 2001, and at the Association of Surgeons of Great Britain and Ireland, Birmingham, 2002.

^f2: Correspondence to: Mr Jason Smith, Colorectal Surgical Unit, West Middlesex University Hospital, Twickenham Road, Isleworth, Middlesex, TW7 6AF, UK. Tel: +442085655972; Fax: +442085655024; E-mail: [email protected]

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Regular ArticleMajor colorectal cancer resection should not be denied to the elderly☆

Abstract

Eur J Surg Oncol

Prevent Med

Eur J Surg Oncol

Cancer Survival 1991–1998

Cancer Statistics – England and Wales

Mortality Statistics: England and Wales

Colorectal cancer in patients over 70 years old

Isr J Med Sci

Decreased operative mortality from colorectal cancer but unchanged treatment results during 30–50 years

Larkartidningren