[Analysis of prognostic factors of rectal cancer in the elderly]

The relation between patient age and outcomes from colorectal cancer surgery is complex. It is generally believed that age should not be a determinant in consideration of prognosis for colorectal cancer patient. But there were few studies on the prognostic factors of rectal cancer in the elderly. We therefore performed a retrospective analysis of clinicopathologic characteristics of rectal cancer in 343 old patients with rectal cancer by univariate and multivariate analysis.

A total of 343 patients (older than 60 years) with rectal cancer were treated surgically during a period of 10 years. R0, R1, and R2 operations were carried out in 261 patients (76.09%), 29 patients (8.45%), and 53 patients (15.45%), respectively. Low anterior resection was performed in 116 patients; 169 patients underwent Miles operation; 58 patients underwent the other operations.

The operation mortality was 0.87%; 149 patients died of occurrence or metastases of the tumor within 108 months postoperatively. Liver, lung, and bone metastases were occurred in 17, 18, and 1 patients, respectively. The mean survival time for all patients was 72.12+/-2.60 months and the overall 3-, 5-, and 10-year survival rates were 69.62%, 55.73%, and 34.23%, respectively. Univariate analysis showed that the predictors of survival were type of operations, radical resection, histological type, diameter of the tumors, depth of tumor invasion, lymphatic invasion, distance metastases, liver and lung metastases. Multivariate analysis showed that only radical resection, lymphatic invasion, liver and lung metastases were independent factors.

The follow prognostic factors can influence the survival of rectal cancer in the elderly: type of operations, nature of operation, histological type, diameter of the tumors, depth of tumor invasion, lymphatic invasion, distance metastases, liver and lung metastases. The independent factors were nature of operation, lymphatic invasion, liver and lung metastases.