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. 2020 Dec;22(12):1924-1932.
doi: 10.1111/codi.15229. Epub 2020 Jul 26.

Outcomes following emergency colorectal cancer presentation in the elderly

P J Webster  1 , N Tavangar Ranjbar  1 , J Turner  1 , A El-Sharkawi  1 , G Zhou  1 , P Chitsabesan  1
Affiliations

Outcomes following emergency colorectal cancer presentation in the elderly

P J Webster et al. Colorectal Dis. 2020 Dec.

Abstract

Aim: Colorectal cancer is predominantly a disease of the elderly and up to 30% of these patients will present as an emergency. We compared the outcomes of 'elderly' patients presenting to our unit with a colorectal cancer emergency over a 10-year period with those of a 'younger' cohort.

Methods: A single centre retrospective review of colorectal cancer emergencies between 1 April 2007 and 1 April 2017 was performed. Patients were separated into two cohorts: 'young' (< 75 years) and 'elderly' (≥ 75 years). Data collected included demographics, disease status, treatment and outcomes.

Results: A total of 341 patients (< 75 years: n = 154; ≥ 75 years: n = 187) presented as a colorectal cancer emergency. Significantly fewer 'elderly' patients underwent curative surgical procedures (72% vs 49%, P < 0.0001) or received adjuvant chemotherapy (56% vs 21%, P < 0.0001). 'Elderly' patients had significantly more postoperative cardio-respiratory complications (7% vs 36%, P < 0.0001), but despite this there was no significant difference in 30-day mortality (7% vs 12%) and survival rates at 1 year (75% vs 74%) or 3 years (56% vs 49%). Elderly patients treated with best supportive care had a median overall survival of just 62 (range 1-955) days.

Conclusion: Patients ≥ 75 years presenting as a colorectal cancer emergency were significantly less likely to undergo emergency curative surgery or receive adjuvant chemotherapy than those < 75 years. However, the 30-day mortality, 1- and 3-year survival rates for patients undergoing curative surgery were comparable.

Keywords: Colorectal cancer; elderly; emergency surgery.

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