Results of colon cancer surgery in patients over 75 years old

ANZ J Surg. 2018 Jan;88(1-2):E11-E15. doi: 10.1111/ans.13666. Epub 2016 Aug 26.

Abstract

Background: Colon cancer is the second most frequent cause of death in both genders. Survival has increased since 1980, although this increase has been lower in patients ≥75 years old. We analyzed the results of surgical treatment for this pathology in this group of patients.

Methods: This retrospective, observational and descriptive study analyzed data relating to 315 patients undergoing colon cancer surgery between January 2010 and December 2011. Surgical results (surgical procedure, mean postoperative stay, isolated lymph nodes, postoperative morbidity and mortality) were compared between patients who were <75 and ≥75 years old.

Results: Statistical significance was observed in the percentages of hypertension (P = 0.001), cardiovascular disease (P = 0.006) and bronchopathy (P = 0.005) for the older group. No differences were found between the groups regarding surgical results, except higher postoperative morbidity and mortality in the ≥75 years old age group (P = 0.02 and P = 0.03, respectively). In the multivariate analysis, the factors associated with postoperative morbidity were age and preoperative albumin levels (P < 0.05). Cancer-specific survival (CSS) was lower in older patients (P < 0.05). The multivariate analysis of survival determined that age and tumour stage are independent predictive factors (P = 0.004 and P = 0.039, respectively), unlike American Society of Anesthesiologists score.

Conclusions: Age does not influence the surgical results after colon cancer resection but is associated with increased postoperative morbidity and mortality. CSS is lower in patients who are ≥75 years old.

Keywords: aged; colectomy; colonic neoplasm; surgery; survival.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Colectomy / adverse effects*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome