Key result
Colorectal cancer surgery in nonagenarians was associated with a 36.8% postoperative complication rate, a 7.0% 30-day mortality rate, and a 31.6% 180-day mortality rate.
Why the study?
With increasing life expectancy, more patients present with colorectal cancer at extreme old age, which is a known risk factor for adverse surgical outcomes. This study evaluated outcomes of colorectal cancer surgery in patients aged 90 or above.
Observational (n=57)
No
Colorectal cancer surgery in nonagenarians can yield favorable outcomes in selected patients, though emergency surgery and a history of ischemic heart disease are significant predictors of postoperative complications.
May inform shared decision-making for selected nonagenarians; leaves open prospective validation of risk predictors.
BACKGROUND: There is a foreseeable trend that life expectancy is on the rise in many parts of the world. More and more patients will present with colorectal cancer at extreme old age and advanced age is a well-known risk factor for adverse outcomes after surgery. The aim of this study is to evaluate the outcomes of colorectal cancer surgery in patients aged 90 or above. METHOD: A retrospective analysis of consecutive patients aged 90 or above who underwent operations for colorectal cancer between January 1996 and December 2015 was performed. The primary outcomes were the complications rate, 30-day and 180-day mortality rates. RESULTS: A total of 57 patients were included in the analysis. The majority of them were women (64.9%). The median age was 92 years. Most of the surgery was of curative intent (77.2%), performed under elective setting (57.9%) and with open approach (78.9%). 36.8% of patients had postoperative complications, with pneumonia being the commonest. The 30-day and 180-day mortality rate was 7 and 31.6% respectively. History of ischemic heart disease and surgery under emergency setting were predictors of postoperative complications. Pneumonia, preoperative leukocytosis and Charlson comorbidity score ≥ 9 were predictors of 180-day mortality. The one and two-year survival rate for elective surgery was 69.7 and 54.5% respectively. CONCLUSION: The outcomes of colorectal cancer surgery for nonagenarians could be favorable in a selected group of patients. Future study on better risk profiling and ways to improve outcomes is warranted.
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Chan et al. (2019) conducted an observational in Colorectal cancer (n=57). Colorectal cancer surgery was evaluated on Postoperative complications. Colorectal cancer surgery in nonagenarians was associated with a 36.8% postoperative complication rate, a 7.0% 30-day mortality rate, and a 31.6% 180-day mortality rate.
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