The influence of age on resection rates and postoperative mortality in 6457 patients with colorectal cancer

Damhuis, Ronald; Wereldsma, J.C.J.; Wiggers, Theo

doi:10.1007/bf00418856

Cited by 49 publications

(35 citation statements)

References 13 publications

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“…Previous studies on colorectal cancer have shown significant higher postoperative mortality rates in the elderly patients [3,5,6,9,11], while series on rectal cancer contradict this finding [12–14]. Emergency surgery, ASA stage and age have been described as independent risk factors influencing on postoperative mortality [5,9,11,13], but compared to colon cancer, emergency presentation is less common in rectal cancer [14].…”

Section: Discussionmentioning

confidence: 99%

Rectal cancer treatment of the elderly

Endreseth

Romundstad²,

Myrvold

et al. 2006

Colorectal Disease

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Section: Discussionmentioning

confidence: 99%

Rectal cancer treatment of the elderly

Endreseth

Romundstad²,

Myrvold

et al. 2006

Colorectal Disease

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“…The post operative mortality of patients less than 60 years was 1% and continually increased with age to about 10% for those over 80. Despite these age associated surgical outcome disparities the authors concluded that surgery should not be denied to elderly patients with acceptable preoperative risk [98]. …”

Section: Chemoprevention For Reducing the Risk Of Colorectal Cancer Riskmentioning

confidence: 99%

“…However, a significant difference was seen in those 80-84 years (8%) rising to 13% in those 85-89 and 20% in nonagenarians (p<0.001) [98]. A French review of over 8,000 cases of colon adenocarcinoma over a 20 year period defined operative mortality in those under 60 to be 1.7%, increasing to 5% in those 60-74 years and 12% in those patients over 75 (p<0.001.…”

Section: Chemoprevention For Reducing the Risk Of Colorectal Cancer Riskmentioning

confidence: 99%

Colon cancer and the elderly: From screening to treatment in management of GI disease in the elderly

Holt

Kozuch

Mewar

2009

Best Practice & Research Clinical Gastroenterology

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Colorectal cancer is one of the commonest tumors in the Westernized world affecting mainly the elderly. This neoplasm in older individuals occurs more often in the right colon and grows more rapidly than in the young, often shows a mucinous histology and mismatch repair gene changes. Effective screening permits discovery of colorectal cancer at an early highly treatable stage and allows for detection and removal of premalignant colorectal adenomas. Screening methods that focus on cancer detection use fecal assays for the presence of blood or altered DNA, those for detection of adenomas (and early cancer) use endoscopic or computerized radiologic techniques. Broad use of screening methods has lowered colorectal cancer development by about 50%. In addition, prevention of the earliest stage of colon carcinogenesis has been shown to be effective in small prospective studies and epidemiologic surveys but have not been employed in the general population. Since 1996 the chemotherapeutic armamentarium for metastatic colorectal cancer has grown beyond 5-fluorouracil to include an oral 5-fluorouracil prodrug, capecitabine as well as irinotecan and oxaliplatin. Three targeted monoclonal antibodies (Moabs), bevacizumab (an anti-vascular endothelial growth factor Moab) and cetuximab/panitumumab, both anti-epidermal growth factor receptor inhibitors, have also earned regulatory approval. Most stage IV patients are treated with all of these drugs over 2 or 3 sequential lines of palliative chemotherapy and attain median survivals approaching 24 months. Lastly, adjuvant oxaliplatin plus 5-fluorouracil for high risk resected stage II and stage III colon cancer patient has led to substantial improvement in cure rates. With appropriate care of age associated comorbidities these treatment modalities are feasible and effective in the geriatric population.

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“…Age, probably by association with increase comorbidity, is an important risk factor for postoperative mortality. The post‐operative mortality rate in patients who undergo surgery for colorectal cancer increases with age (3.7% in patients aged 70–79 years, 9.8% in patients aged 80 to 89 years, and 12.9% in those over 89 years) (grade B evidence) 179 …”

Section: Management Approach To Patients With Acute Lower Gastrointesmentioning

confidence: 99%

Review article: the management of lower gastrointestinal bleeding

Farrell

2005

Aliment Pharmacol Ther

193

129

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SUMMARYSeveral recent advances have been made in the evaluation and management of acute lower gastrointestinal bleeding. This review focuses on the management of lower gastrointestinal bleeding, especially acute severe bleeding. The aim of the study was to critically review the published literature on important management issues in lower gastrointestinal bleeding, including haemodynamic resuscitation, diagnostic evaluation, and endoscopic, radiologic, and surgical therapy, and to develop an algorithm for the management of lower gastrointestinal bleeding, based on this literature review.Publications pertaining to lower gastrointestinal bleeding were identified by searches of the MEDLINE database for the years 1966 to December 2004. Clinical trials and review articles were specifically identified, and their reference citation lists were searched for additional publications not identified in the database searches. Clinical trials and current clinical recommendations were assessed by using commonly applied criteria. Specific recommendations are made based on the evidence reviewed.Approximately, 200 original and review articles were reviewed and graded. There is a paucity of high-quality evidence to guide the management of lower gastrointestinal bleeding, and current endoscopic, radiologic, and surgical practices appear to reflect local expertise and availability of services. Endoscopic literature supports the role of urgent colonoscopy and therapy where possible. Radiology literature supports the role of angiography, especially after a positive bleeding scan has been obtained. Limited surgical data support the role of segmental resection in the management of persistent lower gastrointestinal bleeding after localization by either colonoscopy or angiography.There is limited high-quality research in the area of lower gastrointestinal bleeding. Recent advances have improved the endoscopic, radiologic and surgical management of this problem. However, treatment decisions are still often based on local expertise and preference. With increased access to urgent therapeutic endoscopy for the management of acute upper gastrointestinal bleeding, diagnostic and therapeutic colonoscopy can be expected to play an increasing role in the management of acute lower gastrointestinal bleeding. INTRODUCTIONLower gastrointestinal bleeding is one-fifth to one-third as common as upper gastrointestinal bleeding and generally has a less severe course. The annual incidence rate of lower gastrointestinal bleeding in the US ranges from 20.5 to 27 cases per 100 000 adult population at risk (0.03%). In contrast, the annual incidence rate for upper gastrointestinal bleeding is reported to range from 100 to 200 cases per 100 000. As in upper gastrointestinal bleeding, lower gastrointestinal bleeding stops spontaneously in most cases (80-85%). 1The mean age of patients with lower gastrointestinal bleeding ranges from 63 to 77 years, with a reported mortality rate of 2-4% (Table 1). [2][3][4][5][6][7] The incidence rate of lower gastrointestinal bleed...

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The influence of age on resection rates and postoperative mortality in 6457 patients with colorectal cancer

Cited by 49 publications

References 13 publications

Rectal cancer treatment of the elderly

Rectal cancer treatment of the elderly

Colon cancer and the elderly: From screening to treatment in management of GI disease in the elderly

Review article: the management of lower gastrointestinal bleeding

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