Outcome of colorectal cancer surgery in the early fast-track era with special regard to elderly patients.
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.
Naef
Markus
M
Department of Surgery, Spital STS AG Thun, Switzerland. markus.naef@spitalstsag.ch
Käsemodel
Gabriella Kläy
GK
Mouton
Wolfgang G
WG
Wagner
Hans E
HE
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