title: Management of patients over 80 years of age treated with resection for localised colon cancer: results from a French referral centre.
abstract: BACKGROUND
  Few data are available on management of very elderly colon cancer patients, especially concerning the parameters of therapeutic decisions and the role of geriatricians.
  
  
  METHODS
  We retrospectively reviewed the charts of patients over 80 years of age who underwent surgery for a localised colon cancer in a French academic hospital.
  
  
  RESULTS
  A total of 176 patients underwent surgery (postoperative morbidity and mortality rates: 25% and 6.7%). Adjuvant chemotherapy was discussed at a multidisciplinary team meeting for 91% of stage III patients, but only 13.5% of them were treated. Twenty-five patients relapsed: 19 were discussed at the multidisciplinary meeting and 16 were treated (5 had a metastasectomy). Despite their increase with time, geriatric assessments were infrequent, 17% (33% after 2006), and had no impact on postoperative morbi-mortality. Median overall survival and recurrence-free survival were 65.3 months and 65.1 months, respectively. Age, emergency surgery, and Charlson comorbidity index were independent prognostic factors.
  
  
  CONCLUSIONS
  Selected elderly colon cancer patients have significant access to surgery. However, postoperative morbi-mortality rates remain high and adjuvant chemotherapy rarely prescribed. Perioperative geriatric assessment, especially before surgery, should be routinely proposed to these patients to evaluate its impact on postoperative morbi-mortality and prescription of adjuvant treatment.
authors.affiliation: Institut Curie, René Huguenin Hospital, Department of Medical Oncology, Saint-Cloud, France; University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France. Electronic address: astrid.lievre@curie.fr.
authors.forename: Astrid
authors.initials: A
authors.lastname: Lièvre
authors.affiliation: AP-HP, Kremblin-Bicêtre Hospital, Department of Hepato-Gastroenterology and Digestive Oncology, Le Kremlin Bicêtre, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.affiliation: AP-HP, Ambroise Paré Hospital, Department of Geriatrics, Boulogne-Billancourt, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Cudennec
authors.affiliation: University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France; AP-HP, Ambroise Paré Hospital, Department of Digestive Surgery and Surgical Oncology, Boulogne-Billancourt, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Peschaud
authors.affiliation: AP-HP, Ambroise Paré Hospital, Department of Digestive Surgery and Surgical Oncology, Boulogne-Billancourt, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Malafosse
authors.affiliation: AP-HP, Kremlin-Bicêtre Hospital, Department of Digestive Surgery and Surgical Oncology, Le Kremlin Bicêtre, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Benoist
authors.affiliation: AP-HP, Kremlin-Bicêtre Hospital, Department of Digestive Surgery and Surgical Oncology, Le Kremlin Bicêtre, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Penna
authors.affiliation: AP-HP, Department of Hepato-gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Paris, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Lepère
authors.affiliation: AP-HP, Department of Hepato-gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Paris, France.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vaillant
authors.affiliation: University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France; AP-HP, Ambroise Paré Hospital, Department of Pathology, Boulogne-Billancourt, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Julié
authors.affiliation: University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France; AP-HP, Ambroise Paré Hospital, Department of Geriatrics, Boulogne-Billancourt, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Teillet
authors.affiliation: University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France; AP-HP, Ambroise Paré Hospital, Department of Digestive Surgery and Surgical Oncology, Boulogne-Billancourt, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Nordlinger
authors.affiliation: AP-HP, Department of Hepato-gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rougier
authors.affiliation: Institut Curie, René Huguenin Hospital, Department of Medical Oncology, Saint-Cloud, France; University of Versailles Saint Quentin, Faculty of Health Sciences, Montigny-Le-Bretonneux, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
mesh_terms: D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D009367:Neoplasm Staging; D012017:Referral and Consultation; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Chemotherapy; Colon cancer; Elderly; Surgery; Survival