Key result
Very elderly patients (≥ 80 years) had a significantly poorer overall survival compared to elderly patients (65-79 years) after primary colorectal cancer surgery (HR 1.878).
Why the study?
The study was designed to investigate short-term outcomes and prognosis in elderly and very elderly colorectal cancer patients after primary colorectal cancer surgery using propensity score matching.
Does primary CRC surgery in very elderly patients (≥80 years) result in worse overall and disease-free survival compared to elderly patients (65-79 years)?
Cohort (n=2,084)
No
Does primary CRC surgery in very elderly patients (≥80 years) result in worse overall and disease-free survival compared to elderly patients (65-79 years)?
Hazard Ratio: 1.878 (95% CI 1.488–2.371)
p-value: p=<0.01
Very elderly patients (≥80 years) have worse overall and disease-free survival and longer hospital stays after primary colorectal cancer surgery compared to elderly patients (65-79 years), highlighting the need for individualized surgical strategies.
Supports age-specific survival counseling after colorectal cancer resection; leaves open optimal perioperative interventions in the very elderly.
PURPOSE: The purpose of this study was to investigate the short-term outcomes and prognosis of elderly and very elderly colorectal cancer (CRC) patients after primary CRC surgery using propensity score matching (PSM). METHODS: This study retrospectively collected the medical records of CRC patients ≥ 65 years old undergoing primary CRC surgery from Jan 2011 to Jan 2020. Short-term outcomes, overall survival (OS) and disease-free survival (DFS) were compared between very elderly CRC patients (≥ 80 years old) and elderly CRC patients (65-79 years old). RESULTS: A total of 2084 patients were enrolled for analysis. After PSM, 331 very elderly patients were matched to 331 elderly patients. In terms of short-term outcomes, the very elderly patients had longer postoperative hospital stays (p = 0.007) after PSM. In terms of OS, it was found that age (p < 0.01, HR = 1.878, 95% CI 1.488-2.371), tumor stage (p < 0.01, HR = 1.865, 95% CI 1.603-2.170), overall complications (p < 0.01, HR = 1.514, 95% CI 1.224-1.872) and major complications (p = 0.001, HR = 2.012, 95% CI 1.319-3.069) were independent prognostic factors. For DFS, age (p < 0.01, HR = 1.816, 95% CI 1.579-2.088), tumor stage (p < 0.01, HR = 1.816, 95% CI 1.579-2.088), overall complications (p = 0.002, HR = 1.379, 95% CI 1.128-1.685) and major complications (p = 0.002, HR = 1.902, 95% CI 1.259-2.874) were found to be independent prognostic factors. Moreover, elderly patients had a better OS and DFS than very elderly patients. CONCLUSION: Very elderly patients had a poorer prognosis than elderly patients after primary CRC surgery. Surgeons should be cautious when treating very elderly CRC patients.
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Cheng et al. (2022) conducted a cohort in Colorectal cancer (n=2,084). Very elderly age (≥ 80 years) vs. Elderly age (65-79 years) was evaluated on Overall survival (HR 1.878, 95% CI 1.488-2.371, p=<0.01). Very elderly patients (≥ 80 years) had a significantly poorer overall survival compared to elderly patients (65-79 years) after primary colorectal cancer surgery (HR 1.878).
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