Surgery for advanced colorectal cancer in elderly patients with special emphasis for radio-chemotherapy role
Chiappa, A.; Bertani, E.; Zbar, A.P.; Biffi, R.; Biella, F.; Bellomi, M.; Zampino, G.; Fazio, N.; Poldi, D.; Page, U.; Andreoni, B.
Hepato-Gastroenterology 54(75): 740-745
2007
ISSN/ISBN: 0172-6390 PMID: 17591052 Document Number: 614729
To compare the short- and long-term outcome of older and younger patients with advanced colorectal cancer who underwent elective surgery. Six hundred and ninety-two patients were analyzed. Four hundred and seventy-nine patients were < 70 years (group 1), and 213 were > or = 70 years (group 2). The overall peroperative mortality rate in younger patients was 0.8% (n = 7), and 1.4% (n = 3) in the elderly (p = NS); morbidity was 35% and 42%, respectively (p = NS). On univariate analysis, elderly patients had a worse overall survival (OS) compared to younger, when only patients undergoing postoperative chemo-radiotherapy were considered (54% OS vs. 67% OS at 5 years; p = 0.03). Using logistic regression analysis, tumor stage (p < 0.0001) and radicality of surgery (p < 0.0001), were strongly associated with OS rates in the elderly. Colorectal surgery for malignancy can be performed safely in the elderly. Clinical trials are necessary to understand the real advantage of adjuvant or palliative treatments in these patients.