Surgery for advanced colorectal cancer in elderly patients with special emphasis for radio-chemotherapy role.
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.
Chiappa
Antonio
A
Department of General Surgery, European Institute of Oncology, University of Milano, Milano, Italy. antonio.chiappa@unimi.it
Bertani
Emilio
E
Zbar
Andrew P
AP
Biffi
Roberto
R
Biella
Francesca
F
Bellomi
Massimo
M
Zampino
Giulia
G
Fazio
Nicola
N
Poldi
Davide
D
Page
Ugo
U
Andreoni
Bruno
B
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