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. 2016 Mar;98(3):216-21.
doi: 10.1308/rcsann.2016.0085.

Colorectal cancer outcomes in patients aged over 85 years

O Ng  1 , E Watts  2 , C A Bull  2 , R Morris  3 , A Acheson  2 , A Banerjea  2
Affiliations

Colorectal cancer outcomes in patients aged over 85 years

O Ng et al. Ann R Coll Surg Engl. 2016 Mar.

Abstract

Introduction: The prevalence of colorectal cancer is increasing in the elderly. We examined the treatment and outcomes in our institution of patients aged over 85 years with proven colorectal adenocarcinoma.

Methods: One hundred and five patients were identified and stratified by treatment received: curative surgery (CS), other treatments (OT) or best supportive care (BSC). Data on demographics, staging, treatment and survival was collected and analysed.

Results: Forty two patients received CS, 36 OT and 27 BSC. While the treated groups (CS and OT) were similar in terms of age (p=0.35) and staging (p=0.16), BSC patients were significantly older and had higher stage disease (p<0.01). Survival was significantly poorer among BSC patients, at a mean of 9.7 months (95% confidence interval [CI] 4.7-14.7) versus 41.6 months (95% CI 32.5-50.7) and OT 27.3 months (95% CI 20.4-34.1) for the CS and OT groups (p<0.001). There was no significant survival difference between CS and OT groups within 2 years of treatment (p=0.12). Thereafter, OT patients had a very similar 5-year survival to that of the BSC group, at 13% versus 43% in CS patients (p<0.001).

Conclusions: These data suggest that, up to 2 years following treatment, the risks of resectional surgery for colorectal cancer may neutralise any benefit. However, those that survive beyond this period show improvements. The challenge of improving patient selection is most acute in the growing ageing population, and highlights the current focus on presenting all treatment options to 'a reasonable patient'.

Keywords: Aged 80 and over; Colorectal neoplasms; Mortality.

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Figures

Figure 1
Figure 1
Kaplan-Meier analysis of 5-year survival from colorectal cancer, stratified by treatment arm
Figure 2
Figure 2
Kaplan-Meier analysis of 5-year survival from colorectal cancer following curative surgery, stratified by tumour site
Figure 3
Figure 3
Kaplan-Meier analysis of 5-year survival from colorectal cancer following other treatment, stratified by tumour site
See this image and copyright information in PMC

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