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. 2023 May;93(5):1185-1189.
doi: 10.1111/ans.18188. Epub 2022 Dec 5.

Are health outcomes in the older colorectal cancer patients treated by curative intent surgery any different to the younger patients?

Hinna Azher  1 , Alexander Beath  1 , Elizabeth Degabriele  2 , Ian Faragher  1 , Steven T F Chan  2 , Justin M Yeung  1   2   3
Affiliations

Are health outcomes in the older colorectal cancer patients treated by curative intent surgery any different to the younger patients?

Hinna Azher et al. ANZ J Surg. 2023 May.

Abstract

Background: Colorectal cancer poses a major burden. Its incidence increases with age and older patients with comorbidities have a higher likelihood of major complications. This study investigated the impact of age on health outcomes in colorectal cancer patients treated by surgery.

Methods: A prospective database of all patients undergoing colorectal cancer surgery with curative intent between 2012 and 2017 was used to identify patients. A retrospective review of existing medical records investigating health-related outcomes in colorectal cancer patients undergoing surgery was performed. Primary outcomes measured were overall survival (OS) and disease-free survival (DFS). Difference in restricted mean survival times (RMST) up to a pre-specified time point of 24 months was used to compare four age groups.

Results: Six-hundred and fifty-one patients were divided into four age group categories: ≤65-years (n = 244), 66 to 75-years (n = 213), 76 to 85-years (n = 162) and >85-years (n = 32). Older patients were found to have a higher rate of post-operative medical complications (including confusion) (P = 0.001) and a longer length of stay (LOS) (P = 0.01). There was no difference between the 76 to 85-year age group and >85-year age group in OS and DFS. However, there was a reduced OS in older patients (>65) compared to their younger cohorts (<65) (P = 0.04).

Conclusion: Older patients who undergo curative surgery have reduced OS, increased LOS and higher complication rates. Complex older patients may benefit from geriatric assessment and management in the peri-operative period.

Keywords: colorectal cancer; elderly; older patients; surgical outcomes.

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