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Short- and long-term survival after curative resection for colorectal cancer in nonagenarian patients. | LitMetric

AI Article Synopsis

  • This study examines the outcomes of colorectal cancer surgery in patients aged 90 and older, finding that while advanced age poses risks, careful selection can lead to positive results.
  • Out of 50 patients, with a median age of 92, 50% experienced significant postoperative complications but there were no deaths, showcasing a safe surgical process overall.
  • The research highlights that a patient's preoperative performance status is a key factor influencing long-term survival, indicating that those with better health before surgery tend to have better outcomes.

Article Abstract

Background/objective: With increased life expectancy, the incidence of colorectal cancer in oldest-old patients has been rising. Advanced age is a risk factor for adverse outcomes after surgery. This study aimed to evaluate the short- and long-term outcomes of curative resection for colorectal cancer in nonagenarians.

Methods: Patients who had undergone curative resection for colorectal cancer (CRC) at Stage I to III from January 2010 to December 2019 were included. Cases of emergent surgery were excluded. The clinical characteristics were documented retrospectively, and factors affecting the long-term outcome were analyzed using multivariate analysis.

Results: Fifty patients met the selection criteria. Most of them were women (58.0%), and the median age was 92 years. Among these patients, 29 (58.0%) had a poor performance status (ASA-PS≥3). Laparoscopic surgery was performed in 42.0% of the patients, and 50% of the patients had postoperative complications classified as Clavien-Dindo grade 2 or severer, including 3 patients (6.0%) with grade 3 disease. No postoperative mortality occurred. The 30-day, 180-day, 1-year, 3-year and 5-year survival rates were 100%, 80.4%, 71.0%, 46.3%, and 33.8%, respectively. Multivariate analysis showed that a preoperative poor performance status (ASA-PS≥3) (HR: 3.067; 95% CI: 1.220-7.709; p = 0.017) was an independent prognostic factor for OS.

Conclusion: Curative elective resections for CRC in nonagenarians were performed safely without postoperative mortality. The preoperative performance status was significantly associated with OS after curative elective resection of colorectal cancer in nonagenarians. Our results suggest that excellent long-term outcomes can be achieved in a selected group with a good performance status.

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Source
http://dx.doi.org/10.1016/j.asjsur.2021.04.046DOI Listing

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