Long‐term survival following elective colon cancer surgery in the aged. A population‐based cohort study

Abstract

Aim The number of colorectal cancer patients increases with age. Long-term data support personalized management due to heterogeneity within the older population. This registry-and population-based study aimed to analyse long-term survival, and causes of death, after elective colon cancer surgery in the aged, focusing on patients who survived more than 3 months postoperatively. Methods The data included patients ≥ 80 years who had elective surgery for Stage I-III colon cancer in four Finnish centres. The prospectively collected data included comorbidities, functional status, postoperative outcomes and long-term survival. Univariate and multivariate Cox regression analysis were conducted to determine factors associated with long-term survival. Results A total of 386 surgical patients were included, of whom 357 survived over 3 months. Survival rates for all patients at 1, 3 and 5 years were 85%, 66% and 55%, compared to 92%, 71% and 59% for patients alive 3 months postoperatively, respectively. Higher age, American Society of Anesthesiologists (ASA) score ≥ 4, Charlson Comorbidity Index ≥ 6, tumour Stage III, open compared to laparoscopic surgery and severe postoperative complications were independently associated with reduced overall survival. Higher age (hazard ratio 1.97, 1.14-3.40), diabetes (1.56, 1.07-2.27), ASA score ≥ 4 (3.27, 1.53-6.99) and tumour Stage III (2.04, 1.48-2.81) were the patient-related variables affecting survival amongst those surviving more than 3 months postoperatively. Median survival time for patients given adjuvant chemotherapy was 5.4 years, compared to 3.3 years for patients not given postoperative treatment. Conclusions Fit aged colon cancer patients can achieve good long-term outcomes and survival with radical, minimally invasive surgical treatment, even with additional chemotherapy.

Short and long-term outcomes of elderly patients undergoing left-sided colorectal resection with primary anastomosis for cancer

“…In contrast to some previous reports [ 51 , 52 ], we found impaired long-term outcomes in elderly patients after resection for left-sided CRC. The first 3 months after surgery were suggested as the most critical for these patients [ 51 ] and the results of the present confirmed the importance of the early postoperative period as 90-days mortality reached 7.4% in elderly and only 1.6% in younger counterparts.…”

The Clinical Frailty Scale is a useful tool for predicting postoperative complications following elective colon cancer surgery at the age of 80 years and above: A prospective, multicentre observational study

“…There are some limitations to this study. It was acknowledged 40 50 60 [3,35]. Future studies using these multicentre data will focus on longterm results with outcomes, and especially functional recovery.…”

“…More extensive patient data are needed to confirm the possible prognostic trends such as with CFS, ASA, MNA‐SF and GFR. Moreover, a longer follow‐up would be necessary to evaluate the complete impact of invasive cancer treatment [3,35]. Future studies using these multicentre data will focus on long‐term results with outcomes, and especially functional recovery.…”

Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study

“…However, laparoscopic surgery could not completely substitute open surgery in several circumstances, including vast tumor invasions and emergency operations. 1,[19][20][21][22][23] In fact, due to various reasons, surgeons mainly perform open surgery in our hospital. However, due to the factors such as surgical injury, organ stretch ischemia, inflammatory exudate stimulation in abdominal cavity and large incision in the abdominal wall, patients can feel moderate-to-severe pain after surgery.…”

“…Colon cancer is one of the most common malignant tumors in digestive tract, the morbidity and mortality are increasing year by year, and so far surgery remains the mainstream curative treatment for colon cancer. [1][2][3] Postoperative pain can delay the wound healing, the first ambulation and the recovery of intestinal tract, leading to the patient's body in a stress status, which results in the damage of immune function, thus promoting the recurrence and metastasis of tumor after surgery, and delaying the overall postoperative recovery speed. [4][5][6][7][8][9][10][11][12] It has been demonstrated that scientific and reasonable pain management is helpful to reduce complications and accelerate the recovery of patients.…”