The Impact of the Risk Factor “Age” on the Early Postoperative Results of Surgery for Colorectal Carcinoma and Its Significance for Perioperative Management

Abstract

The risks and benefits of surgery for colorectal cancer in old patients have not been unequivocally defined. The present investigation was carried out in 309 hospitals as a prospective multicenter study. In the period between 1 January 2000 and 31 December 2001, a total of 19,080 patients were recruited for the study; 16,142 (84.6%) patients were younger than 80 years (<80) and 2932 (15.4%) were 80 years and older (> or =80). Significant differences between the age groups were observed for general postoperative complications (22.3% for <80 years; 33.9% for > or =80). Specific postoperative complications were identical in both groups. Overall, significantly elevated morbidity and mortality rates were found with increasing age (morbidity: 33.9% vs. 43.5%; mortality: 2.6% vs. 8.0%). The distribution of tumor stages revealed a significantly higher percentage of locally advanced tumors in the older age group (stage II: 28.0% vs. 34.4%). In contrast, no increase in metastasizing tumors was found in the older age group (stage IV: 17.4% vs. 14.1%). Logistic regression showed that, in concert with a number of other parameters, age is a significant influencing factor on postoperative morbidity and mortality. The increase in postoperative morbidity and mortality rates associated with aging is a result of the increase in general postoperative complications, in particular, pneumonia and cardiovascular complications. Age as such does not represent a contraindication for surgical treatment. The short-term outcome and quality of life are of overriding importance for the geriatric patient.

Locally advanced colorectal cancer: results of surgical treatment and prognostic factors

“…In the consulted literature, postoperative complication rates vary from 20% to 42% (11) (average 30%), and mortality has been reported to occur in 1.7% to 13% (24) . Especially in elderly patients, these procedures are generally associated with higher morbidity rates when compared to standard colorectal resections (23,30,31) . In our series, 10 (43.5%) out of 23 patients presenting complications were older than 65 years.…”

Prevalence of and Risk Factors for Morbidity After Elective Left Colectomy

“…12,14,37,39 Therefore, inclusion of patients undergoing emergency surgery might mask other factors influencing the postoperative course.…”

Short-term outcomes after surgery for colorectal cancer in Turkish patients aged 70 and above

“…Different thresholds of 65 (7), 70 (8-10), 75 (6, 11), 80 (2,12), and 85 (3) years have been used in other studies. We chose 70 years as the threshold because of the shorter life expectancy in our country compared to that in Western countries.…”

“…Elderly patients have more comorbid conditions and higher rates of emergency operations and later stage diseases (1). However, they form a heterogeneous group of patients with significant differences in their general states of health (2).…”