[Colorectal tumor surgery in the elderly: results of quality assurance]

The age group ≥ 80 years has become of great importance in the surgical treatment of colorectal cancer due to the demographic changes over the years. To assess patient risk, early postoperative and oncologic long-term outcome 64,740 patients with colorectal cancer were enrolled in various nationwide multicenter observational studies through two study periods (2000-2004 and 2009-2011) and analyzed according to various age groups, in particular ≥ 80 years. The percentage of octogenarians increased from 2009 to 2011, which was associated with an increased patient risk. In 70  % of patients ≥ 80 years old the operative risk was preoperatively classified as ASA stages III and IV. There was a high age-independent resection rate of colon cancer; however, the rectal cancer resection rate in octogenarians was significantly lower. In the age group ≥ 80 years there was a relatively high rate of emergency surgical interventions because of an ileus due to tumor-induced lumen obstruction leading to a hospital mortality rate in both study periods of 18.8 % and 17.9 %, respectively. In the octogenarians there were more locally advanced colon cancer lesions of stage T3/4 but less tumor lesions with distant metastases. The age-corrected tumor-free 5-year survival rate of the octogenarians with colon cancer of tumor stage UICC I-III was identical to that of younger patients.