title: Outcome of colorectal cancer surgery in the early fast-track era with special regard to elderly patients.
abstract: Colorectal cancer (CRC) is one of the most frequently diagnosed cancers in the Western world. Differentiated surgical therapy in the last years have made a curative resection possible in more than 80% of the cases. Two hundred ninety consecutive patients with colorectal cancer over 6 years were enrolled in a retrospective follow-up study based on the electronic patient record, with special regard to patients more than 70 years old. The outcome was evaluated using the following endpoints: resectability, 30-days morbidity (local and general complications), mortality, re-operation rate, and survival. The mean age of the 290 patients was 71.5 years; 176 patients were more than 70 years old and the male to female ratio was 148:142. Three hundred eight tumors had been diagnosed in the 290 patients. Tumor staging was as follows: stage I, 18.5%; stage II, 30%; stage III, 32%; and stage IV, 19.5%. A local R0 resection was made possible in 97% of the tumors. The 30-days morbidity incidence for patients younger/older than 70 years was 33%/57% (P < 0.05), the mortality incidence was 2.6%/3.4% (P value not significant), and the reoperation rate was 7.0%/9.1% (P value not significant). Anastomotic leaks occurred in 3.5% of the patients. The 1-, 2-, and 5-year survival rates were 81.4%, 66.3%, and 61.5%, respectively. Our findings show that colorectal carcinomas may be operated with mostly curative intent with a low mortality rate, a high R0 resection rate, and similar complications, mortality, and re-operation rates, even in patients more than 70 years old.
authors: Department of Surgery, Spital STS AG Thun, Switzerland. markus.naef@spitalstsag.ch
authors: Markus
authors: M
authors: Naef
authors: Gabriella Kläy
authors: GK
authors: Käsemodel
authors: Wolfgang G
authors: WG
authors: Mouton
authors: Hans E
authors: HE
authors: Wagner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome