Colorectal cancer in senior patients – are we doing it well?
Authors:
D. Kostrouch; L. Martínek; J. Hoch
Authors‘ workplace:
Chirurgická klinika 2. LF Univerzity Karlovy a FN Motol
přednosta: prof. MUDr. J. Hoch, CSc.
Published in:
Rozhl. Chir., 2017, roč. 96, č. 5, s. 197-201.
Category:
Original articles
Overview
Introduction:
Geriatric patients form a significant part of patients with colorectal cancer and their numbers will probably continue to increase. Analysis of the quality of care provided to seniors and the results from their treatment are currently gaining more attention. The aim of this study was to compare how often standard oncological therapy is administered to seniors with colorectal cancer and to compare their results with younger patients along with complications of the therapy.
Method:
A retrospective analysis of data from 170 patients with the diagnosis of colorectal cancer undergoing an elective curative surgical procedure in 2014 and 2015 was performed. Patients were divided into three groups according to their age (<60 years old, 60−79 years old, ≥80 years old). We compared their ASA score, tumor stage (I−IV), tumor localization (colon, rectum), incidence of serious complications grade 3−5 on the Clavien-Dindo scale and adherence to standard oncological treatment in the individual age groups.
Results:
Patients 80 years and older had significantly higher ASA scores (p=0.0001) and significantly higher stages of tumors according to TNM-7 classification (p=0.0413) in comparison to younger patients. Differences in numbers of serious complications (<60 years – 14%, 60−79 years – 13%, ≥80 years − 30%, p=0.1499) did not reach statistical significance. Seniors underwent modified oncological treatment (<60 years – 6%, 60−79 years – 9%, ≥ 80 years − 30%, p = 0.0095) significantly more frequently in comparison to younger age groups.
Conclusion:
The application of standard multimodal oncological treatment is possible even in selected patients that are 80 years and older. Implementation of more reliable methods to objectively predict postoperative complications can become a tool to modify the treatment and improve the results of surgical care in elderly patients.
Key words:
geriatric patients – oncosurgery − complex geriatric assessment − colorectal cancer
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2017 Issue 5
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