Colorectal cancer surgery in elderly patients: presentation, treatment, and outcomes

This study was designed to characterize the presentation, care, and outcomes of persons older than 75 years, compared with persons 50 to 74 years of age, selected for colorectal cancer.

Patients over the age of 50 years who had surgery for colon or rectal cancer at the Mount Sinai Hospital between 1997 and 2006 were identified. Data were obtained from a colorectal cancer database and from office and hospital records. Patients were assigned to two groups: 50 to 74 years old and 75 years and older.

There were 623 patients in the younger group (mean age, 62.6 years) and 275 in the older group (mean age, 81.5 years). The in-hospital mortality rate was 1% in the younger group compared with 4.2% in the older (P = 0.002). The overall five-year survival was 68.7% and 57.3% in the younger and older groups, respectively, whereas colorectal cancer-specific five-year survival was not significantly different (74.0% vs. 74.7%). There were significant differences between the two groups with respect to cancer location, American Society of Anesthesiologists' score, stage, proportion detected by screening, length of stay, and use of chemotherapy.

Long-term colorectal cancer-related outcomes in the older group are similar to the outcomes in younger patients, suggesting that the decision to operate should not be based on age alone.