Outcomes in elderly patients following surgery for colorectal cancer in the veterans affairs health care system.
OBJECTIVE
To compare 30-day and 5-year mortality in elderly vs. younger patients following surgical resection for colorectal cancer.


METHODS
A cohort study of patients admitted to VA hospitals with a new diagnosis of colorectal cancer who underwent surgical resection between October 1990 and September 2000. Cumulative survival rates (30-day and 5-year) were calculated from Kaplan-Meier estimates and adjusted risks of death were estimated using Cox proportional hazards models.


RESULTS
We identified 34,888 individuals with a new diagnosis of colorectal cancer between October 1990 and September 2000, of whom 22 633 (65%) underwent surgical resection. The 30-day mortality following resection for rectal and colon cancer, respectively, for patients <65 years was 2.1 and 2.8% compared with 4.9 and 5.6% for those > or =65 years. The 5-year cumulative survival for rectal and colon cancer for patients <65 years was 54.0 and 57.6% compared with 44.5 and 46.6% for those > or =65 years. In patients > or =65 years with rectal or colon cancer, after adjustment, 30-day mortality was 2 times greater and 5-year mortality was 1 times greater than in younger patients.


CONCLUSIONS
Older age is an independent predictor of increased short-term and long-term mortality following surgery in patients with rectal and colon cancer.
Rabeneck
L
L
Department of Medicine, Division of Gastroenterology, University of Toronto, Toronto, Canada. linda.rabeneck@sw.ca
Davila
J A
JA
Thompson
M
M
El-Serag
H B
HB
D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data