Impact of age-related comorbidity on results of colorectal cancer surgery.
OBJECTIVE
To analyze the correlation between preexisting comorbidity and other clinicopathological features, short-term surgical outcome and long-term survival in elderly patients with colorectal cancer (CRC).


METHODS
According to age, 403 patients operated on for CRC in our department were divided into group A (< 70 years old) and group B (> or = 70 years old) and analyzed statistically.


RESULTS
Rectal localization prevailed in group A (31.6% vs 19.7%, P = 0.027), whereas the percentage of R0 resections was 77% in the two groups. Comorbidity rate was 46.2% and 69.1% for group A and B, respectively (P < 0.001), with a huge difference as regards cardiovascular diseases. Overall, postoperative morbidity was 16.9% and 20.8% in group A and B, respectively (P = 0.367), whereas mortality was limited to group B (4.5%, P = 0.001). In both groups, patients who suffered from postoperative complications had a higher overall comorbidity rate, with preexisting cardiovascular diseases prevailing in group B (P = 0.003). Overall 5-year survival rate was significantly better for group A (75.2% vs 55%, P = 0.006), whereas no significant difference was observed considering disease-specific survival (76.3% vs 76.9%, P = 0.674).


CONCLUSIONS
In spite of an increase in postoperative mortality and a lower overall long-term survival for patients aged > or = 70 years old, it should be considered that, even in the elderly group, a significant number of patients is alive 5 years after CRC resection.
Pedrazzani
Corrado
C
Department of Human Pathology and Oncology, Unit of Surgical Oncology, University of Siena, Policlinico Le Scotte, Siena, Italy. pedrazzani@unisi.it
Cerullo
Guido
G
De Marco
Giovanni
G
Marrelli
Daniele
D
Neri
Alessandro
A
De Stefano
Alfonso
A
Pinto
Enrico
E
Roviello
Franco
F
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult