Patients and methods: From 2001, cases of 76 patients who underwent Cur A resection for colorectal cancer and preoperative prognostic nutritional index (PNI) assessment were analyzed in terms of clinicopathological factors, surgical outcomes, and prognosis.
Results: Median age of the 36 men and 40 women included in the study was 83 years. Median PNI was 42.1. Twenty-four patients had a PNI below 40. There were 36 patients with pulmonary dysfunction, and 60 patients with D2 or wider LN dissection. Median operating time was 177 minutes. Postoperative complications were reported in 48 patients and SSI in 15 patients. Postoperative hospital stay was 16 days. During a median 30 month follow-up period, there were 16 deaths, including 8 from cancer-related causes and 8 from other disease-related causes. Patients with a PNI below 40 often had fewerD2 LN dissections(p=0.082)and significantly shorter operating times(p=0.015). First gait and first flatus were observed significantly later(p=0.0051, 0.0307). There were no significant differences in postoperative complication rates, SSI, postoperative hospital stay, cause of death, or survival.
Conclusions: In the elderly aged over 80-years-old, because those with a PNI below 40 underwent resection with fewer LN dissections and shorter operating time, there were no significant differences in postoperative complications, cause of death, or prognosis. These results suggest that PNI could be a selection factor for surgical procedure in elderly patients aged over 80 years.