title: Differences in the therapeutic approach to colorectal cancer in young and elderly patients.
abstract: OBJECTIVE
  To analyze differences in the therapeutic approach to and tumor-related mortality of young and elderly colorectal cancer (CRC) patients.
  
  
  METHODS
  This was a descriptive study of a retrospective cohort, based on administrative databases, of all patients with CRC diagnosed or treated in our institution. We extracted data on sociodemographic characteristics, comorbidity, type of cancer, type of treatment received, survival time, and cause of death. We compared differences between a young group (YG) (age <75 years) and an older group (OG) (age ≥75 years) and assessed the variables associated with receiving different therapeutic options (multivariate analysis) and with survival time (Cox proportional hazards models).
  
  
  RESULTS
  The study included 503 patients (YG, 320; OG, 183), with mean ages of 63.1 years in the YG and 81.8 years in the OG. No differences were observed between the groups in degree of differentiation, extension, tumor stage, or comorbidity. After adjustment for gender, comorbidity, and tumor localization and extension, YG patients were more likely than OG patients to receive surgery, radiotherapy, and chemotherapy and less likely to receive palliative care. After a median follow-up of 36.5 months, YG patients had a longer tumor-specific survival time than OG patients (36.41 months vs 26.05 months). After further adjustment, the YG had a lower tumor-specific mortality risk (hazard ratio, 0.66) than the OG.
  
  
  CONCLUSIONS
  In comparison with younger patients, elderly CRC patients are undertreated, mainly because of their age and not because of their tumor type or comorbidity. Elderly patients have a significantly shorter tumor-specific survival time, partially because of this undertreatment.
authors.affiliation: Department of Geriatric Medicine, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain. jserra.hgugm@salud.madrid.org
authors.forename: José A
authors.initials: JA
authors.lastname: Serra-Rexach
authors.forename: Ana B
authors.initials: AB
authors.lastname: Jimenez
authors.forename: María A
authors.initials: MA
authors.lastname: García-Alhambra
authors.forename: Rosa
authors.initials: R
authors.lastname: Pla
authors.forename: Maite
authors.initials: M
authors.lastname: Vidán
authors.forename: Paz
authors.initials: P
authors.lastname: Rodríguez
authors.forename: Javier
authors.initials: J
authors.lastname: Ortiz
authors.forename: Pilar
authors.initials: P
authors.lastname: García-Alfonso
authors.forename: Miguel
authors.initials: M
authors.lastname: Martín
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome