Overall survival of elderly colorectal cancer (CRC) patients
Published Date: 15th July 2020
Publication Authors: Javed M, Airey G, Kearsey C, Samad A, Chadwick M, Rajaganeshan R
Purpose
Advances in surgical techniques and perioperative care have improved cancer‐related outcomes. This study aims to describe the outcomes of elderly who had curative surgery or symptomatic management for CRC.
Methods
Retrospective study of consecutive CRC patients between 2014 to 2016 in a DGH, who were 70 years old or above. Demographic and perioperative data were obtained. Survival analysis was conducted using Kaplan Meier method.
Results
191 patients were identified (M: F = 100:91); 149 patients underwent curative surgical resections while 42 received symptomatic management. Overall survival (OS) in the operative group and symptomatic treatment group was 51.6 months and 20.3 months respectively, P value < 0.05. Operative details included: elective vs emergency = 128: 21, laparoscopic vs open = 88: 61, right colon resections vs left colon / rectal resections = 62: 87. Median length of hospital stay was 14.4 days (range 1–48), 29 (13.4%) patients require HDU/ITU admission post‐operatively and disease recurrence was identified in 48 patients (32.2%). OS in the elective group was higher compared to the emergency group, hazard ratio 0.23 (CI 0.12–0.43), P value < 0.05. Reasons for symptomatic management included; metastatic disease (n = 6, 14.3%), patient choice (n = 22, 52.4%), un‐resectable disease (n = 2, 4.7%) and individual deemed unfit for surgery (n = 15, 33.3%). Treatment options in the symptomatic treatment group included; best supportive care (n = 28, 62.2%), de‐functioning stoma n = 4, 8.9%) and palliative chemotherapy / radiotherapy (n = 13, 35.7%).
Conclusion
For carefully selected elderly patients, primary curative surgery offers a reliable long‐term outcome, therefore surgery should not be denied on age alone.
Javed, MA; Airey, G; Doss, A; Kearsey, C; Samad, A; Chadwick, M; Rajaganeshan, R. (2020). Overall survival of elderly colorectal cancer (CRC) patients. Colorectal Disease. 22 (S1), 17