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. 2023 Nov 17;408(1):438.
doi: 10.1007/s00423-023-03179-7.

Long-term outcomes in elderly patients after elective surgery for colorectal cancer within an ERAS protocol: a retrospective analysis

Andrea Navarra  1 , Iride Porcellini  2 , Francesco Mongelli  3   4 , Sotirios Georgios Popeskou  2 , Fabian Grass  1   5 , Dimitri Christoforidis  2   6   5
Affiliations

Long-term outcomes in elderly patients after elective surgery for colorectal cancer within an ERAS protocol: a retrospective analysis

Andrea Navarra et al. Langenbecks Arch Surg. .

Abstract

Purpose: The number of elderly patients with a diagnosis of colorectal cancer (CRC) is increasing. Considering short life expectancy and multiple comorbidities, surgery may not always be the best treatment option.

Methods: We included all consecutive patients aged 80 years and older who underwent elective resection for CRC following Enhanced Recovery after Surgery (ERAS) protocol between January 2011 and May 2021. The primary endpoint was overall survival, secondary endpoints were 30-day morbidity, and the rate of return to pre-operative living conditions 3 months after surgery.

Results: Ninety-four patients were included. Mean age was 84.6 ± 3.6 years, 49 patients (52%) were female. Most patients (77.6%) were ASA score ≥ 3. Laparoscopic resections were performed in 85 patients (90.4%), involving 69 (73.4%) colonic and 25 (26.6%) rectal resections. A stoma was constructed in 22 patients (23%), and reversed in 12 (54.5%). Twenty-two patients (23.4%) experienced a Clavien-Dindo ≥ 3 complication, and 2 patients (2.1%) died. The median length of hospital stay was 8 (interquartiles: 6-15) days. Sixty-six patients (70.2%) were discharged home directly and 26 (27.7%) to rehabilitation or postacute care institutes. At three months after surgery, eighty-two patients (96.5%) returned to their pre-operative living conditions directly or after short-term rehabilitation. Mean follow-up was 53 ± 33 months, estimated 5-year overall survival was 60.3% (95%CI 49.5-71.1%), and disease-free survival was 86.3% (95%CI 78.1-94.4%).

Conclusions: Our study suggests that elderly patients undergoing elective surgery have a high potential to return to preoperative living conditions and good overall- and disease-free survivals, despite significant postoperative morbidity.

Keywords: Colorectal cancer; Colorectal surgery; ERAS; Elderly; Long-term outcomes.

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References

    1. Xi Y, Xu P (2021) Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 14:101174. https://doi.org/10.1016/j.tranon.2021.101174 - DOI - PubMed - PMC
    1. Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, McCullough ML, Patel AV, Ma J, Soerjomataram I, Flanders WD, Brawley OW, Gapstur SM, Jemal A (2018) Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin 68:31–54. https://doi.org/10.3322/caac.21440 - DOI - PubMed
    1. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, Cercek A, Smith RA, Jemal A (2020) Colorectal cancer statistics, 2020. CA Cancer J Clin 70:145–164. https://doi.org/10.3322/caac.21601 - DOI - PubMed
    1. Ladoy A, Vallarta-Robledo JR, De Ridder D, Sandoval JL, Stringhini S, Da Costa H, Guessous I, Joost S (2021) Geographic footprints of life expectancy inequalities in the state of Geneva. Switzerland Sci Rep 11:23326. https://doi.org/10.1038/s41598-021-02733-x - DOI - PubMed
    1. Cesari M, Calvani R, Marzetti E (2017) Frailty in older persons. Clin Geriatr Med 33:293–303. https://doi.org/10.1016/j.cger.2017.02.002 - DOI - PubMed

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