Outcome of surgery for rectal cancer in octogenarians

The aim of this study was to assess the outcome of surgery for rectal cancer in patients 80 years of age or more.

A retrospective study of 29 patients older than 80 years, who presented in our institution between 1997 and 2001 with the diagnosis of rectal adenocarcinoma, was undertaken.

Median follow-up was 54 (range 27-78) months, and the median age of patients was 85 (range 80-94) years. Twenty-four out of 29 patients (83%) underwent surgery, 23 being operated electively. Twenty out of 24 patients (83%) underwent resection with curative intent, while four patients (17%) had a palliative procedure. Median hospital stay was 13 (range 10-35) days. Postoperative morbidity and mortality were 46% and 12.5%, respectively. However, when considering only elective procedures with curative intent, operative mortality was 5%. At the time of last follow-up, 13 patients were alive, five of them with no evidence of recurrent disease at 5 years, for an overall 2- and 5-year survival rate of 80% and 67%, respectively. Four out of the 7 deaths, which occurred after surgery, were due to medical causes unrelated to cancer.

In our institution, two thirds of patients older than 80 years who presented with rectal cancer underwent surgery with curative intent. In this selected population, good results in terms of short-term survival can be achieved, at the price of an elevated postoperative morbidity. Whenever possible, treatment with curative intent should be considered in patients with rectal cancer, irrespective of the age.