Surgical treatment for colorectal cancer in octogenarians and nonagenarians

Advances in surgical techniques and perioperative care have improved cancer-related outcomes. However, there are still concerns regarding the safety of octogenarian and nonagenarian patients during surgery. Clinicians may be reluctant to perform a radical resection for colorectal cancer and administer adjuvant or palliative cytotoxic chemotherapy to octogenarian and nonagenarian patients. In the elderly, setting a primary goal based on multidisciplinary team discussions prior to treatment is important. The overall treatment scheme, risks, and potential benefits should be discussed with elderly patients and their families. In this review, we will discuss multidimensional aspects of colorectal cancer surgery for octogenarian and nonagenarian patients with respect to age-related physiological declines, preoperative assessments, appropriate surgical procedures, and short-term and oncologic outcomes. In this era of an aging society, clinicians should provide objective evidence to octogenarian and nonagenarian patients regarding estimated short-term and oncologic outcomes. However, there is a limited number of studies concerning outcomes following colorectal cancer surgery in octogenarians and nonagenarians. In the future, a prospective study with a larger cohort would be helpful to collect objective data on octogenarian and nonagenarian patients.