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[Colorectal carcinoma in old age]
H E Wagner1, U Aebi, P A Barbier
1Universitätsklinik für viszerale Chirurgie, Inselspital, Bern.
Schweizerische Medizinische Wochenschrift
|October 10, 1987
Summary
Prompt assessment and elective surgery are crucial for elderly patients with suspected colorectal cancer. Early intervention can prevent complications, reduce emergency surgeries, and improve survival rates in this vulnerable population.
Area of Science:
- Geriatric Oncology
- Surgical Oncology
Context:
- Colorectal cancer (CRC) presents unique challenges in elderly patients (>80 years).
- Comorbidities are prevalent (54%), increasing surgical risks.
- CRC complications like ileus or perforation necessitate emergency interventions (27%).
Purpose:
- To evaluate the outcomes of colorectal cancer management in octogenarians.
- To assess the impact of prompt diagnosis and surgical planning on mortality and survival.
- To advocate against therapeutic nihilism in elderly cancer patients.
Summary:
- 84 elderly patients with CRC were analyzed, revealing a 74% resection rate, with 64% curative and 36% palliative outcomes.
- Early tumor stages (UICC I/II) were observed in 51% of cases.
- Operative mortality was 14.3%, with 3- and 5-year survival rates of 38% and 30%, respectively.
Impact:
- Rapid assessment and preoperative optimization for elective surgery can significantly lower mortality in elderly CRC patients.
- Timely intervention reduces the incidence of emergency surgeries and associated complications.
- Individualized evaluation and treatment are essential, challenging the notion of diagnostic and therapeutic nihilism in the elderly.