title: Colorectal cancer in geriatric patients: endoscopic diagnosis and surgical treatment.
abstract: OBJECTIVE
  To investigate the prevalence of colorectal cancer in geriatric patients undergoing endoscopy and to analyze their outcome.
  
  
  METHODS
  All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included. Patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival.
  
  
  RESULTS
  Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%) surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients). Patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for non-operated patients amounted to 46% and 13% respectively.
  
  
  CONCLUSIONS
  Nearly two-thirds of 88 geriatric patients with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence, the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatric patients is demonstrated.
authors.affiliation: First Department of Medicine/Gastroenterology, General Hospital Wels, A-4600 Wels/Austria, Grieskirchnerstrasse 42, Austria. andreas.kirchgatterer@klinikum-wels.at
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirchgatterer
authors.forename: Pius
authors.initials: P
authors.lastname: Steiner
authors.forename: Dietmar
authors.initials: D
authors.lastname: Hubner
authors.forename: Eva
authors.initials: E
authors.lastname: Fritz
authors.forename: Gerhard
authors.initials: G
authors.lastname: Aschl
authors.forename: Josef
authors.initials: J
authors.lastname: Preisinger
authors.forename: Maximilian
authors.initials: M
authors.lastname: Hinterreiter
authors.forename: Bernhard
authors.initials: B
authors.lastname: Stadler
authors.forename: Peter
authors.initials: P
authors.lastname: Knoflach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome