Curative colorectal resections in patients aged 80 years and older: clinical characteristics, morbidity, mortality and risk factors

Ihedioha, U; Gravante, Gianpiero; Lloyd, Geraint; Sangal, Sam; Sorge, Roberto; Singh, Baljit; Chaudhri, Sanjay

doi:10.1007/s00384-012-1626-0

Cited by 28 publications

(33 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, among the eight domains in the CGA, the comorbidities and the ADL domains were significantly and independently associated with major postoperative complications. Previous studies reported that advanced age, advanced tumor stage, emergency surgery, blood transfusion, malnutrition, diabetes, and pre-existing cardiac pathology were risk factors for postoperative complications in elderly patients with CRC [171819]. …”

Section: Discussionmentioning

confidence: 99%

Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer

Lee

Kim

et al. 2016

Ann Coloproctol

View full text Add to dashboard Cite

PurposeThis study was conducted to identify the effectiveness of a preoperative comprehensive geriatric assessment (CGA) for predicting postoperative morbidity in elderly patients who underwent surgery for colorectal cancer.MethodsElderly patients (≥70 years old) who underwent surgery for colorectal cancer at a tertiary hospital in Korea were identified, and their cases were analyzed using data from a prospectively collected database to establish an association between major postsurgical complications and 'high-risk' patient as defined by the CGA.ResultsA total of 240 patients, with a mean age of 76.7 ± 5.2 years, were enrolled. Ninety-five patients (39.6%) were classified as "high-risk" and 99 patients (41.3%) as having postoperative complications. The univariate analysis indicated that risk factors for postoperative complications were age, American Society of Anesthesiologists physical status classification, serum hemoglobin, carcinoembryonic antigen, cancer stage, and "high-risk" status. The multivariable analyses indicated that "high-risk" status (odds ratio, 2.107; 95% confidence interval, 1.168–3.804; P = 0.013) and elevated preoperative carcinoembryonic antigen (odds ratio, 2.561; 95% confidence interval, 1.346–4.871, P = 0.004) were independently associated with postoperative complications. A multivariable analysis of the individual CGA domains indicated that high comorbidities and low activities of daily living were significantly related with postoperative complications.ConclusionA preoperative CGA indicating "high-risk" was associated with major postoperative complications in elderly patients who underwent surgery for colorectal cancer. Thus, using the CGA to identify elderly colorectal-cancer patients who should be given more care during postoperative management may be clinically beneficial.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer

Lee

Kim

et al. 2016

Ann Coloproctol

View full text Add to dashboard Cite

show abstract

“…The incidence of accompanying disease and high ASA score have been shown as independent risk factors for increased postoperative morbidity and mortality (18,19). When additional diseases of the patients were evaluated, it was determined that 88.9% of the emergency surgery group and 71.7% of the elective surgery group had one or more co-morbid diseases.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

Bayar

Yılmaz

Akıncı

et al. 2016

UCD

View full text Add to dashboard Cite

Objective: Colorectal cancer is still one of the most common causes of cancer related deaths in the world despite improvements in diagnosis and treatment modalities, and application of community-based screening methods. Symptoms of colorectal cancer are non-specific and usually manifest following local progression. A number of patients with advanced stage colorectal cancer present to emergency departments with obstruction as the first sign of disease without any previous symptoms. This presentation is an indication for emergency surgery that has a high rate of morbidity and mortality. In this study, we aimed to determine the factors associated with early diagnosis and survival by comparing postoperative results of colorectal cancer patients who underwent surgery under emergency or elective situation. Material and Methods:Files of colorectal patients treated between 2009-2013 were retrospectively analyzed. Data on patient age, gender, operation type, intraoperative results, length of hospital stay, co-morbidities, postoperative complications and pathological results were evaluated and compared.Results: There was no statistical difference between groups in terms of age, gender, and pathology results (p>0.05). The difference between groups in terms of postoperative length of hospital stay, presence of co-morbid diseases, pathological stage, and postoperative complications was statistically significant (p<0.05). Length of hospital stay, advanced stage on admission, complications such as surgical site infection, evisceration, and anastomosis leakage rates were higher in patients in the emergency surgery group. Conclusion:Risk groups should be determined in order to diagnose colorectal cancer patients at an early stage while they are still asymptomatic, and this information should be incorporated into effective screening programs. This approach will be beneficial to treatment outcomes, complication rates, length of hospital stay, and survival and treatment results. INTRODUCTIONColorectal cancer (CRC) is one of the most frequent cancers with more than one million people worldwide being diagnosed with CRC annually, which is the most common gastrointestinal tract cancer (1). The majority of these neoplasms are endoluminal adenocarcinoma derived from the mucosa, and over 95% of CRC patients benefit from surgery or colonoscopic interventions for premalignant polyps with early diagnosis (2). Despite advances in diagnosis and treatment and dissemination of communitybased screening, colorectal cancer remains to be one of the main reasons of cancer-related deaths in the world (3).

show abstract

“…Here, we totally identified 17058 CC patients aged ≥80, which accounted for 26.0% in all patients from 2004 to 2012. Elder patients, especially for patients aged ≥80, not only has been thought as an independent prognostic factor regarding with survival, but also has been associated with different clinical and histological features9131415. Therefore, patients aged ≥80 were highly heterogeneous population, which should be discriminately evaluated in the consideration of cancer diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Elder CC patients have distinct characteristics that need to be taken into account regarding lymph node evaluation, especially for patients aged ≥801314. However, little attention has been paid to this issue, which contributed to a distinct lack of data on these elder patients.…”

mentioning

confidence: 99%

Exploration of the Optimal Minimum Lymph Node Count after Colon Cancer Resection for Patients Aged 80 Years and Older

Guan

Chen

Jiang

et al. 2016

Sci Rep

View full text Add to dashboard Cite

The elderly colon cancer (CC) patients are increasing and represent a heterogeneous patient group. The objectives of this study were to identify the features of lymph node examination and to explore the optimal minimum lymph node count after CC resection for patients aged ≥80. Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 65719 CC patients in stage I-III between 2004 and 2012, 26.0% of patients were aged ≥80. The median node count decreased with increasing age, which were 25.5, 20.2, 17.8 and 16.9 for patients aged 20–39, 40–59, 60–79, and ≥80. The rate of ≥12 nodes and the rate of node positivity for patients aged ≥80 were obviously lower than younger patients. Using X-tile analysis, we determined 9 nodes as the optimal node count for patients aged ≥80. Then, we compared the 5-year cancer specific survival (CSS) between patients with ≥9 nodes and <9 nodes. The results showed the 5-year CSSs were improved for patients with ≥9 nodes. Furthermore, the rate of node positivity and survival under the 9-node measure were equal to 12-node measure. Therefore, the lymph node examination should be discriminately evaluated for elder patients, and 9-node measure was available for patients aged ≥80.

show abstract

Curative colorectal resections in patients aged 80 years and older: clinical characteristics, morbidity, mortality and risk factors

Cited by 28 publications

References 22 publications

Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer

Use of a Comprehensive Geriatric Assessment to Predict Short-Term Postoperative Outcome in Elderly Patients With Colorectal Cancer

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients

Exploration of the Optimal Minimum Lymph Node Count after Colon Cancer Resection for Patients Aged 80 Years and Older

Contact Info

Product

Resources

About