Are health outcomes in the older colorectal cancer patients treated by curative intent surgery any different to the younger patients?

• Published in: ANZ journal of surgery Vol. 93; no. 5; pp. 1185 - 1189
• Main Authors: Azher, Hinna, Beath, Alexander, Degabriele, Elizabeth, Faragher, Ian, Chan, Steven T. F., Yeung, Justin M.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.05.2023; Blackwell Publishing Ltd
• Subjects: Age; Age groups; Aged; Cancer; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms; Comorbidity; Complications; Disease-Free Survival; elderly; Humans; Incidence; Medical records; older patients; Patients; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Progression-Free Survival; Retrospective Studies; Surgery; surgical outcomes; Survival; older patients; colorectal cancer; surgical outcomes; elderly
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.18188

Background Colorectal cancer poses a major burden. Its incidence increases with age and older patients with comorbidities have a higher likelihood of major complications. This study investigated the impact of age on health outcomes in colorectal cancer patients treated by surgery. Methods A prospective database of all patients undergoing colorectal cancer surgery with curative intent between 2012 and 2017 was used to identify patients. A retrospective review of existing medical records investigating health‐related outcomes in colorectal cancer patients undergoing surgery was performed. Primary outcomes measured were overall survival (OS) and disease‐free survival (DFS). Difference in restricted mean survival times (RMST) up to a pre‐specified time point of 24 months was used to compare four age groups. Results Six‐hundred and fifty‐one patients were divided into four age group categories: ≤65‐years (n = 244), 66 to 75‐years (n = 213), 76 to 85‐years (n = 162) and >85‐years (n = 32). Older patients were found to have a higher rate of post‐operative medical complications (including confusion) (P = 0.001) and a longer length of stay (LOS) (P = 0.01). There was no difference between the 76 to 85‐year age group and >85‐year age group in OS and DFS. However, there was a reduced OS in older patients (>65) compared to their younger cohorts (<65) (P = 0.04). Conclusion Older patients who undergo curative surgery have reduced OS, increased LOS and higher complication rates. Complex older patients may benefit from geriatric assessment and management in the peri‐operative period. This study investigated the impact of age on health outcomes in colorectal cancer patients treated by surgery. Older patients who undergo curative surgery have reduced overall survival, increased length of stay and higher complication rates. Complex older patients may benefit from geriatric assessment and management during their surgery.