title: Surgery for advanced colorectal cancer in elderly patients with special emphasis for radio-chemotherapy role.
abstract: OBJECTIVE
  To compare the short- and long-term outcome of older and younger patients with advanced colorectal cancer who underwent elective surgery.
  
  
  METHODS
  Six hundred and ninety-two patients were analyzed. Four hundred and seventy-nine patients were < 70 years (group 1), and 213 were > or = 70 years (group 2).
  
  
  RESULTS
  The overall peroperative mortality rate in younger patients was 0.8% (n = 7), and 1.4% (n = 3) in the elderly (p = NS); morbidity was 35% and 42%, respectively (p = NS). On univariate analysis, elderly patients had a worse overall survival (OS) compared to younger, when only patients undergoing postoperative chemo-radiotherapy were considered (54% OS vs. 67% OS at 5 years; p = 0.03). Using logistic regression analysis, tumor stage (p < 0.0001) and radicality of surgery (p < 0.0001), were strongly associated with OS rates in the elderly.
  
  
  CONCLUSIONS
  Colorectal surgery for malignancy can be performed safely in the elderly. Clinical trials are necessary to understand the real advantage of adjuvant or palliative treatments in these patients.
authors.affiliation: Department of General Surgery, European Institute of Oncology, University of Milano, Milano, Italy. antonio.chiappa@unimi.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Zbar
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Francesca
authors.initials: F
authors.lastname: Biella
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
authors.forename: Giulia
authors.initials: G
authors.lastname: Zampino
authors.forename: Nicola
authors.initials: N
authors.lastname: Fazio
authors.forename: Davide
authors.initials: D
authors.lastname: Poldi
authors.forename: Ugo
authors.initials: U
authors.lastname: Page
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care; D015996:Survival Rate; D016896:Treatment Outcome