Decrease in 30-day and one-year mortality over time in patients aged ≥75 years with stage I-III colon cancer: A population-based study

Eur J Surg Oncol. 2018 Dec;44(12):1889-1893. doi: 10.1016/j.ejso.2018.08.010. Epub 2018 Aug 29.

Abstract

Background: Monitoring time trends of cancer mortality is essential. Thirty-day mortality is an important surgical outcome measure, though postoperative mortality exceeds to one year after surgery in patients with colorectal cancer. The aim of this nationwide observational study was to assess changes over time in 30-day and one-year mortality in patients with stage I-III colorectal cancer.

Methods: All surgically treated patients with stage I-III colorectal cancer, diagnosed between 2009 and 2013 were selected from the Netherlands Cancer Registry. Changes in 30-day and one-year mortality were assessed using logistic regression by tumour localisation (colon, rectum) and age group (<75 years, ≥75 years).

Results: Overall, 41,186 patients were included. Among patients with colon cancer ≥75 years, 30-day mortality decreased from 8.3% in 2009 to 6.2% in 2013 (p-value for trend = 0.011), and one-year mortality from 18.5% in 2009 to 15.0% in 2013 (p-value for trend = 0.007). No significant differences in mortality over time were observed for patients <75 years with colon cancer and for patients with rectal cancer.

Conclusion: Thirty-day and one-year mortality decreased over time in patients ≥75 years with stage I-III colon cancer, though the absolute decrease is small. However, 30-day mortality and in particular the one-year mortality are both still high in older patients with colorectal cancer and will need to be focused on to further improve outcomes for these patient subgroups.

Keywords: Colorectal cancer; Elderly; Stage I–III; Time trends.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colonic Neoplasms / mortality*
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / surgery
  • Female
  • Humans
  • Male
  • Neoplasm Staging
  • Netherlands / epidemiology
  • Registries
  • Time Factors