Long-Term Outcome Following Surgery for Colorectal Cancers in Octogenarians: A Single Institution’s Experience of 204 Patients

Abstract

Surgery for octogenarians with colorectal cancers is associated with significant morbidity and mortality rates which are associated with advanced age, emergency surgery, and Charlson Comorbidity Index >3. Long-term survival is dependent on the stage of the malignancy and the presence of severe perioperative complications.

Laparoscopic colorectal surgery is safe and benefits octogenarian patients with malignant disease: a matched case-control study comparing laparoscopic and open colorectal surgery

“…The Barcelona trial [15] showed that laparoscopic surgery had a better 5-year survival rate in stage III patients and comparable survival rates for the other stages, whilst the CLASICC [15] and COST [16] trials showed comparable 3-year survival and recurrence rates. A Singapore case series showed favourable oncological outcomes in an octogenarian population following resection of their tumour, with an overall survival for stage I, II, III and IV diseases of 62.3, 60.4, 51.6 and 19.3 months, respectively [1]. Furthermore, other studies suggest that the disease-specific survival rate between the elderly and younger patients is similar, and curative intent should be considered regardless of age [17,18].…”

“…The elderly population in Singapore and the world is increasing, and with it, the incidence of colorectal cancer in this age group [1,2].…”

“…It is postulated that older patients have a higher risk of complications due to their frailty and higher number of comorbid conditions, which could result in poorer overall and disease-free survival [1]. There are few studies that analyse the mortality and morbidity of laparoscopic surgery specifically in the older population.…”

Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiation in Elderly Patients

“…However, older patients may have complex comorbidities and diminished cardiopulmonary reserves, which are associated with increased morbidity and mortality from colorectal surgery. 10,11 Laparoscopic colorectal surgery has become more prevalent worldwide. Several studies have suggested that laparoscopic surgery for colorectal cancer may have some benefits such as less wound pain, earlier recovery, and better cosmetic results, with similar postoperative outcomes to open surgery.…”

Caecal pneumatosis is not an absolute contraindication for endoluminal stenting in patients with acute malignant large bowel obstruction

“…Complications from emergency surgery for large bowel obstruction are considerable; with mortality rates ranging from 10% to 30%, compared with less than 5% for elective surgery . It has recently been reported that these post‐operative complications can have a significant impact on the long‐term survival of patients . Post‐operative diarrhoea after caecal resection in a total colectomy can also have an adverse impact on the quality of life .…”