title: Surgery of colorectal carcinoma in patients aged over 80.
abstract: BACKGROUND
  The incidence of colorectal carcinoma increases rapidly in aged patients. We investigated retrospectively the differences in treatment relative to the patients' age.
  
  
  METHODS
  A total of 394 patients with colorectal carcinoma (group I: > or =80 years, n = 197; group II: 60-79 years, n = 197) were analyzed in an average period of 4 years in relation to surgery, comorbidities, postoperative morbidity, mortality, survival and recurrence.
  
  
  RESULTS
  Patients > or =80 years had a significantly higher rate of comorbid conditions (p = 0.04; cardiovascular, p = 0.01; diabetes mellitus, p < 0.05) and more carcinomas in the sigmoid/rectum (72% vs. 67%; p < 0.05). Tumor stage, R0 resection rate, and overall complication rate were not influenced by age. The 30-day mortality rate was significantly higher in group I (12% vs. 3%; p = 0.02). Emergency surgical procedures were required significantly more often in group I (14%) than in group II (5%; p = 0.003). The 5-year survival rate among patients in group I was 30.1% compared to 50.5% among patients in group II (p < 0.0001).
  
  
  CONCLUSIONS
  Elderly patients have a higher rate of comorbidity and a higher postoperative 30-day mortality rate. Tumor stage, R0 resection rate, and overall postoperative complication rate do not appear to be influenced by age. The higher rate of emergency operations on patients > or =80 years is associated with the higher 30-day mortality. Even in patients aged > or =80 years, attention should focus on the long-term oncological results, after appropriate assessment of the preoperative risk.
authors.affiliation: Department of Surgery, Comprehensive Cancer Center, University of Tübingen, Hoppe-Seyler-Strasse 3, Tübingen, Germany.
authors.forename: Claudius
authors.initials: C
authors.lastname: Falch
authors.forename: Thomas
authors.initials: T
authors.lastname: Kratt
authors.forename: Stefan
authors.initials: S
authors.lastname: Beckert
authors.forename: Andreas
authors.initials: A
authors.lastname: Kirschniak
authors.forename: Derek
authors.initials: D
authors.lastname: Zieker
authors.forename: Ingmar
authors.initials: I
authors.lastname: Königsrainer
authors.forename: Stefan
authors.initials: S
authors.lastname: Löb
authors.forename: Joerg T
authors.initials: JT
authors.lastname: Hartmann
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Bjorn L D M
authors.initials: BL
authors.lastname: Brücher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome