Surgery for large bowel cancer in people aged 75 years and older

Three hundred ten predominantly male patients who were 75 years of age or older and had surgery for colorectal carcinoma had a hospital mortality rate of 9 percent and a cancer-related five-year survival of 50 percent. These results and a detailed analysis of the causes of complications and mortality were compared with the outcome of 710 patients who were treated concurrently and who were younger than 75 years. Tumors in older patients had a tendency to occur on the right side and were more locally advanced. Increased mortality was particularly attributable to sepsis and cardiovascular causes. Increased morbidity was due principally to respiratory and urinary problems. There were no significant differences, however, in wound or anastomotic complications, nor was therapy for the older patients more costly. The indications for surgical resection for colorectal cancer in patients aged 75 years and older should be the same as those for any younger group.