Feasibility and outcomes of colorectal cancer surgery in patients aged 85 and older.

Abstract

Background: With the changing age distribution, the number of elderly patients with colorectal cancer is expected to increase. Postoperative morbidity and mortality rates are reported to be higher in elderly patients; however, surgical resection remains the only option to preserve quality of life and prolong survival. This study aimed to evaluate the feasibility of colorectal surgery in patients aged 85 years and older based on postoperative outcomes.

Methods: A total of 477 patients who underwent surgery for colorectal cancer were categorized into two groups: the 75-84 years group (N.=362) and the ≥85 years group (N.=115). Preoperative comorbidities, operative outcomes, postoperative complications, and long-term survival were analyzed retrospectively.

Results: Regarding preoperative comorbidities, dementia was significantly more prevalent in the ≥85 years group than in the 75-84 years group (P=0.002). In terms of laboratory findings, preoperative hemoglobin and serum albumin levels were significantly lower in the ≥85 years group than in the 75-84 years group (P=0.001 and P<0.001, respectively). The incidence of postoperative pneumonia and delirium was significantly higher in the ≥85 years group than in the 75-84 years group (P=0.001and P=0.011, respectively). The mean postoperative survival of patients aged ≥85 years exceeded six years.

Conclusions: In colorectal cancer patients aged 85 and older with dementia, the incidence of postoperative pneumonia is high; therefore, cognitive function assessment is essential when considering surgery.