The Characteristics of Colorectal Cancer in Patients Older than 80 Years

Lee, Jae Myeong; Kim, Hee Cheol; Park, In Ja; Kim, Dae Dong; Yu, Chang Sik; Kim, Jin Cheon

Abstract

PURPOSE: The frequency of surgery for elderly Koreans with colorectal cancer has increased because of the current life expectancy rates. The purpose of this study is to identify the characteristics of colorectal cancer in very elderly patients, to determine the optimal treatment decision, and to evaluate the patients prognosis.
METHODS
Between 1989~2005, 181 patients (96 men and 85 women, median age 82) over the age of 80 with colorectal cancer underwent surgery at OO hospital, Korea. Medical records with these patients' co-morbidities, symptoms, clinico-pathologic characteristics, complications, survival, and other relevant data were obtained and analyzed retrospectively.
RESULTS
The principal clinical symptoms were bleeding (45.3%) and bowel habit change (40.9%). Of these patients, 126 had at least one preoperative co-morbidity, and hypertension (29.3%), and cardiac disease (16.0%) were common. Curative surgery was performed in 82.9% (n=150). Emergency surgery was performed in 6.1% (n=11), and the principal cause was obstruction. The most common location of the colorectal cancer was the rectum (39.8%). There were postoperative complications in 36.4% of the patients, including voiding difficulty (12.2%) and wound infection (9.9%). The thirty-day mortality rate was 0.6% (n=1). A preoperative, low PaO2 level significantly increased the incidence of postoperative complications (P=0.036). The five-year survival rate of the curative resection group was higher than that in the remaining patients (44.3% vs. 38.8%, P<0.001).
CONCLUSIONS
Although the preoperative morbidity was high in these very elderly patients, it could be lowered with strict patient management. In addition, these patients showed a relatively good survival rate. Therefore, we believe that major, curative, colorectal surgery should be performed in selected very elderly patients.