Outcomes of surgery for colorectal cancer in patients age 80 years and older.

Abstract

Three hundred patients treated for colorectal cancer during the period 1975-1980 were divided into two groups (less than 80 yr, 236; greater than or equal to 80 yr, 64). No statistically significant differences were seen between the two groups for American Joint Committee on Cancer (AJCC) stage, site, and length of stay. Operative mortality (30 days) was associated with type of treatment (p less than 0.01), stage (p less than 0.05), and age (p less than 0.01) but not with site of cancer. Five-year survival curves excluding 30-day mortalities showed no significant difference between the two age groups. Proportional hazards linear model (multivariate) analysis showed that, whereas 5-yr survival was related to stage (p less than 0.001) and type of operation, patients greater than or equal to 80 did not have a significantly greater risk of death than patients less than 80 yr. Since the age of the patient influences operative morality, but not 5-yr survival, increasing attention needs to be paid to minimizing operative risk by careful preoperative assessment, optimization of underlying cardiac, pulmonary, and nutritional deficiencies, and monitoring numerous physiologic variables during the intraoperative and postoperative period. Resection of cancer should not be limited or denied on the basis of age alone.