Curative resection for colorectal cancer in the elderly. Prognostic factors and five-year follow-up.
The purpose of this perspective study was to evaluate which prognostic factors predict long-term survival and disease-free survival (DFS) of elderly patients (> or = 65 years) who underwent surgery for colorectal carcinoma. Between January 1992 and December 1998, 196 colorectal cancer patients > or = 65 years (114 M; 82 F; mean age: 75 years; range: 65-92) underwent surgery. One hundred forty-five (74%) of them underwent curative surgery and emergency surgery was more common in patients > or = 75 years of age than among those younger than 75 years (39% vs 23%; p = 0.01). The overall peroperative mortality rate was 3% (n = 6). The median length of hospital stay was 18 days (range: 3-86 days). By univariate analysis, intraoperative bleeding (> or = 500 cc; p = 0.002), length of surgery (> or = 240 min.; p = 0.004), and rectal cancer (p = 0.0001) were associated with complications. By multivariate analysis, only rectal cancer (p = 0.002) was associated with complications. The overall 1, 3-, and 5-year survival rate and DFS rate were 97%, 82%, 74%, and 86%, 64% and 60% respectively. Using multivariate analysis only tumour stage (p < 0.0001) and peroperative blood transfusions (> or = 500 cc; p = 0.006) were associated with outcome. Treatment decisions in elderly patients with colorectal carcinoma should not be influenced by the chronologic age of the patient.
Staudacher
C
C
Department of Emergency Surgery--Surgical Oncology, University of Milan. staudacher.carlo@hsr.it
Chiappa
A
A
Zbar
A P
AP
Bertani
E
E
Biella
F
F
D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000401:mortality / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D016019:Survival Analysis