What happens when we don't operate?

Response to Bethune et al.

“…Additionally, though not discussed by Bethune et al . in their letter but emphasized by Bethune and Arulampalam previously , we do agree that the key challenge is determining who is fit for elective and even emergent resection in the nonagenarian population. Yet this can be difficult, as evidenced by some of the high in‐hospital mortality rates reported by countries such as Slovakia, Poland and Latvia in the European Surgical Outcomes Study .…”

Response to ‘Colorectal cancer resection in the Australian nonagenarian patient’

“…As has already been discussed in this journal , operative outcomes tell only part of the story. We do not know what would have happened to these patients had they not had an operation.…”

Should preoperative optimization of colorectal cancer patients supersede the demands of the 62‐day pathway?

“…Largely a disease of the elderly with 58% of cases diagnosed aged over 70 years , the incidence of significant other comorbidities is typically high. In those over 80 years, postoperative 30‐day mortality is 13−15%, rising to double that at 60 days . Two‐thirds will not return to normal activity and will require an increased level of care packages .…”

“…In those over 80 years, postoperative 30-day mortality is 13À15%, rising to double that at 60 days [8,9]. Two-thirds will not return to normal activity and will require an increased level of care packages [8,9].…”