Results of colon cancer surgery in patients over 75 years old

Domínguez, Lucinda Pérez; Alvarado, Nieves Cáceres; Novella, Ángeles Toscano; Núñez, José Enrique Casal

doi:10.1111/ans.13666

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…We focused our analysis on patients with rectal cancer because they accounted for over 80% of those receiving radiation therapy. Consistent with these results, Pérez Domínguez L et al found that age did not affect the prognosis after colon cancer resection but was associated with more postoperative morbidity and mortality [ 22 ].…”

Section: Discussionsupporting

confidence: 55%

Clinicopathologic features and prognostic factors for patients with colorectal cancer who are 75 years and older

et al. 2017

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Colorectal cancer (CRC) is common and can be considered as a disease of older adults. About one half of the cases were diagnosed in patients over 70 years of age. Decision-making about treatment for these older patients can be complicated by age-related physiological changes, impaired functional status, limited social support, and comorbidities. Many trials excluded patients using an upper limit of 75 years of age. Little is known about prognostic factors in patients who are over this age limit. In this study, we conducted an analysis in the Surveillance, Epidemiology and End Results (SEER) database to identify specific clinicopathologic features and prognostic factors for these vulnerable cancer patients (N= 293,616). They were predominantly female and had more stage I and II diseases in comparison to younger patients. On average, these patients had lower 5-year cause-specific mortality than younger patients (41.98% vs. 63.14%, P<0.001). Gender, marital status, ethnicity, Tumor-Node-Metastasis stage, grade, histologic subtype, tumor size, status of surgery and radiotherapy were all independent prognostic factors for these elderly CRC patients. In particular, surgery could improve prognosis for all CRC patients with the exception of those who are older than 94 years old and with stage III disease. The identified clinicopathologic features and prognostic factor will help guide treatment decision-making for this oldest old subset of patients with CRC.

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Section: Discussionsupporting

confidence: 55%

Clinicopathologic features and prognostic factors for patients with colorectal cancer who are 75 years and older

et al. 2017

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“…Previous studies mainly focused on perioperative clinical outcomes of elderly patients with colorectal cancer. 11,12 However, as relatively more studies were conducted on octogenarian or younger patients, few studies focused exclusively on nonagenarian patients who underwent colorectal surgery. [13][14][15][16][17][18][19] The postoperative short-and long-term complication rates in this study were 35.0% and 15.0%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

Jeon

Han

Wonsuk

et al. 2021

The American Surgeon

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Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

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“…Surgery remains the mainstream treatment for elderly CRC. Some studies have reported that elderly patients undergoing open colorectal surgery are associated with high mortality (2.1–7.9%) and morbidity (17.7–50.0%) when compared with younger people [ 4 , 5 , 6 ]. Advanced age is associated with increasing comorbidities, such as diabetes mellitus, chronic kidney disease, and cardiovascular or pulmonary disease, which increase surgical morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study

Chern

You

Cheng

et al. 2021

Cancers

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Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I–III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.

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Results of colon cancer surgery in patients over 75 years old

Abstract: Age does not influence the surgical results after colon cancer resection but is associated with increased postoperative morbidity and mortality. CSS is lower in patients who are ≥75 years old.

Cited by 7 publications

References 21 publications

Clinicopathologic features and prognostic factors for patients with colorectal cancer who are 75 years and older

Clinicopathologic features and prognostic factors for patients with colorectal cancer who are 75 years and older

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study

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