N0 Stage colon cancer: prognostic role of age in relation to tumor site.

This work investigates the prognostic role of advanced age as a risk factor for recurrence in a population of patients undergoing surgery for N0 stage colon cancer, and also evaluates whether that role is affected by tumor location. A population of 129 consecutive patients who underwent radical surgery for N0 stage colon cancer was selected. Patients were subdivided into three age groups: <65, 65-80 and >80. The only correlation found in the examined population between age and clinical-pathological features was between advanced age (>80) and tumor location in the right side of the colon. Overall survival (OS) and disease- free survival (DFS) were significantly lower in patients over 80 than in the other two classes. Two multivariate analyses were carried out: when tumor location was not considered, age >80 represented a negative prognostic factor for risk of recurrence, regardless of the other factors examined. This role was also confirmed when tumor location was considered. As hypothesized by several authors, the role of advanced age which emerges from this study is mainly due to the increased fragility of elderly patients caused by multiple pathophysiological factors, but it does not necessarily represent an absolute contraindication to surgery. The role played by tumor location remains controversial, as more and more studies show that right colon cancer (RCC) is a biological entity distinct from left colon cancer (LCC). Further studies are required to examine right and left colon cancers as two separate diseases.