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. 2009 Dec 7;15(45):5706-11.
doi: 10.3748/wjg.15.5706.

Impact of age-related comorbidity on results of colorectal cancer surgery

Corrado Pedrazzani  1 , Guido Cerullo, Giovanni De Marco, Daniele Marrelli, Alessandro Neri, Alfonso De Stefano, Enrico Pinto, Franco Roviello
Affiliations

Impact of age-related comorbidity on results of colorectal cancer surgery

Corrado Pedrazzani et al. World J Gastroenterol. .

Abstract

Aim: To analyze the correlation between preexisting comorbidity and other clinicopathological features, short-term surgical outcome and long-term survival in elderly patients with colorectal cancer (CRC).

Methods: According to age, 403 patients operated on for CRC in our department were divided into group A (< 70 years old) and group B (> or = 70 years old) and analyzed statistically.

Results: Rectal localization prevailed in group A (31.6% vs 19.7%, P = 0.027), whereas the percentage of R0 resections was 77% in the two groups. Comorbidity rate was 46.2% and 69.1% for group A and B, respectively (P < 0.001), with a huge difference as regards cardiovascular diseases. Overall, postoperative morbidity was 16.9% and 20.8% in group A and B, respectively (P = 0.367), whereas mortality was limited to group B (4.5%, P = 0.001). In both groups, patients who suffered from postoperative complications had a higher overall comorbidity rate, with preexisting cardiovascular diseases prevailing in group B (P = 0.003). Overall 5-year survival rate was significantly better for group A (75.2% vs 55%, P = 0.006), whereas no significant difference was observed considering disease-specific survival (76.3% vs 76.9%, P = 0.674).

Conclusion: In spite of an increase in postoperative mortality and a lower overall long-term survival for patients aged > or = 70 years old, it should be considered that, even in the elderly group, a significant number of patients is alive 5 years after CRC resection.

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Figures

Figure 1
Figure 1
Kaplan-Meier estimates of survival probability for R0 population in group A (< 70 yr; 174 pts) and B (≥ 70 yr; 137 pts). Postoperative, tumor-related and -unrelated deaths were included (Log-rank test, P = 0.006).
Figure 2
Figure 2
Kaplan-Meier estimates of disease-specific survival probability for R0 population in group A (< 70 yr; 174 pts) and B (≥ 70 yr; 137 pts). Postoperative and tumor-related deaths were included (Log-rank test, P = 0.674).
See this image and copyright information in PMC

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