When and how should surgery be performed in senior colorectal cancer patients?

Ketelaers, Stijn H. J.; Fahim, Milad; Rutten, H.J.T.; Smits, Anke B.; Orsini, R.G.

doi:10.1016/j.ejso.2020.01.007

Cited by 13 publications

(9 citation statements)

References 75 publications

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“…In the past, surgical treatment options were not offered to older patients as frequently due to an increased complication rate and higher mortality rate in this population [2,3]. Currently, with more frequent use of minimally invasive surgery and improvement of perioperative care within a multidisciplinary setting, these risks have decreased [4]. Analyses of Dutch national data showed that the overall 30-day and one-year survival of older patients operated for colon cancer improved over time.…”

Section: Introductionmentioning

confidence: 99%

The survival gap between young and older patients after surgical resection for colorectal cancer remains largely based on early mortality: A EURECCA comparison of four European countries.

Bahadoer¹,

Bastiaannet²,

Peeters³

et al. 2022

Journal of Geriatric Oncology

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Section: Introductionmentioning

confidence: 99%

The survival gap between young and older patients after surgical resection for colorectal cancer remains largely based on early mortality: A EURECCA comparison of four European countries.

Bahadoer¹,

Bastiaannet²,

Peeters³

et al. 2022

Journal of Geriatric Oncology

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“…What is of paramount importance in older patients, is that minimal invasive surgical techniques evoke a less intensive immune response in comparison to open surgery, thus reducing the effects of perioperative trauma [16]. This could be an explanation for the improved recovery seen after minimal invasive surgery with less postoperative pain, shorter hospital admissions and less postoperative and cardiopulmonary complications [5,15,17,18] -a key element in the recovery of older patients [14][15][16][17][18].…”

Section: Treatment Of Colon Cancer In Older Patientsmentioning

confidence: 99%

Colon cancer in the older population

Kenig

2021

Nowotwory. Journal of Oncology

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Fifty percent of new diagnoses of colorectal cancer are made in patients aged over 70 years, and 25% are aged 80 years or over. Older patients tend to have locally advanced colon cancer, with negative lymph nodes and without distant metastasis. Frequently the colon cancer is located on the right side. There is still a belief that older patients can not manage curative treatment regimens. This is based on the results of older studies showing higher rates of short-term morbidity and mortality. At present, we are observing significant improvements in the outcomes of older patients with colon cancer in high volume centers. This could be due to better preoperative staging, increased use of minimally invasive techniques, better anesthesiology and perioperative care, awareness of complications, expertise and high-volume care. A standardized pre-operative diagnostic approach, individualized surgical technique selection and tailored postoperative care are essential for the successful treatment of older patients. Furthermore, counseling and shared decision-making should be based on modern insights in surgical outcomes rather than outdated data.

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“…Idealerweise sollte vor einer Operation ein Frailty Screening durchgeführt und der Patient in einer elektiven Situation operiert werden. Grund dafür sind die deutlich verbesserten Ergebnisse in Bezug auf postoperative Morbidität und Mortalität [64].…”

Section: Resektable Stadienunclassified

Gastrointestinale Tumoren beim älteren und alten Patienten

Schulte

Ebert

Reißfelder³

et al. 2020

Z Gastroenterol

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ZusammenfassungÄltere Patienten (65 Jahre und älter) stellen die Mehrheit der Patienten mit einer Krebsdiagnose dar. Für Ösophaguskarzinome liegt der Altersgipfel in der siebten bis achten Lebensdekade. Bei Magenkarzinomen ist 1/3 der Patienten älter als 75 Jahre, und ca. 45 % der Kolonkarzinom-Patienten sind ≥ 75 Jahre alt.Aufgrund bestehender Komorbiditäten, altersbedingter Veränderungen und Polypharmazie stellen ältere und alte Patienten eine besondere Herausforderung in der Tumortherapie dar.In Studien sind diese Patienten meist deutlich unterrepräsentiert, und dezidierte „Elderly“-Studien sind rar. Neue Operationsverfahren mit der minimalinvasiven Technik wie der Laparoskopie oder mit Telemanipulatoren liefern gerade für das Ösophagus- und Magenkarzinom Vorteile, die zukünftig für alte und ältere Patienten die postoperative Morbidität in Bezug auf kardiale und pulmonale Komplikationen deutlich senken können.Bezüglich Chemotherapie zeigt sich eine gute Verträglichkeit von Fluoropyrimidinen und Oxaliplatin; von Triple-Therapien sollte eher Abstand genommen werden. Gerade die Immuntherapie bietet aufgrund des besseren Nebenwirkungsprofils eine interessante Alternative zur Standardchemotherapie.

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When and how should surgery be performed in senior colorectal cancer patients?

Cited by 13 publications

References 75 publications

The survival gap between young and older patients after surgical resection for colorectal cancer remains largely based on early mortality: A EURECCA comparison of four European countries.

The survival gap between young and older patients after surgical resection for colorectal cancer remains largely based on early mortality: A EURECCA comparison of four European countries.

Colon cancer in the older population

Gastrointestinale Tumoren beim älteren und alten Patienten

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