title: The impact of age on complications, survival, and cause of death following colon cancer surgery.
abstract: Given scarce data regarding the relationship among age, complications, and survival beyond the 30-day postoperative period for oncology patients in the United States, this study identified age-related differences in complications and the rate and cause of 1-year mortality following colon cancer surgery.
  
  
  
  The NY State Cancer Registry and Statewide Planning and Research Cooperative System identified stage I-III colon cancer resections (2004-2011). Multivariable logistic regression and survival analyses assessed the relationship among age (<65, 65-74, ⩾75), complications, 1-year survival, and cause of death.
  
  
  
  Among 24 426 patients surviving >30 days, 1-year mortality was 8.5%. Older age groups had higher complication rates, and older age and complications were independently associated with 1-year mortality (P<0.0001). Increasing age was associated with a decrease in the proportion of deaths from colon cancer with a concomitant increase in the proportion of deaths from cardiovascular disease. Older age and sepsis were independently associated with higher risk of colon cancer-specific death (65-74: HR=1.59, 95% CI=1.26-2.00; ⩾75: HR=2.57, 95% CI=2.09-3.16; sepsis: HR=2.58, 95% CI=2.13-3.11) and cardiovascular disease-specific death (65-74: HR=3.72, 95% CI=2.29-6.05; ⩾75: HR=7.02, 95% CI=4.44-11.10; sepsis: HR=2.33, 95% CI=1.81-2.99).
  
  
  
  Older age and sepsis are associated with higher 1-year overall, cancer-specific, and cardiovascular-specific mortality, highlighting the importance of geriatric assessment, multidisciplinary care, and cardiovascular optimisation for older patients and those with infectious complications.
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Aquina
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Mohamedtaki A
authors.initials: MA
authors.lastname: Tejani
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Adan Z
authors.initials: AZ
authors.lastname: Becerra
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Zhaomin
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Hensley
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Arsalani-Zadeh
authors.affiliation: New York State Cancer Registry, New York State Department of Health, Albany, NY 12204, USA.
authors.forename: Francis P
authors.initials: FP
authors.lastname: Boscoe
authors.affiliation: New York State Cancer Registry, New York State Department of Health, Albany, NY 12204, USA.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Schymura
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Katia
authors.initials: K
authors.lastname: Noyes
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.|Center for Colon and Rectal Surgery, Florida Hospital Medical Group, University of Central Florida College of Medicine, Orlando, FL 32803, USA.
authors.forename: John Rt
authors.initials: JR
authors.lastname: Monson
authors.affiliation: Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA.
authors.forename: Fergal J
authors.initials: FJ
authors.lastname: Fleming
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D003110:Colonic Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D011184:Postoperative Period; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States