Rates of colorectal cancer in elderly people are increasing, but there has been relatively little study of this disease in the “oldest” of the old or very elderly patients.
This study focused on outcomes data to determine how an aggressive surgical approach impacted the long-term survival of patients aged 85 and older.
In the study, 2,237 patients with colorectal cancer were prospectively enrolled at St. Vincent’s University Hospital in Dublin, Ireland (90 were age 85 or older; 2,147 were less than 85 years of age) and followed to determine long-term survival. There were more women in the very elderly group compared to the under 85 cohort (66% vs. 47%) and a greater proportion of right sided tumors. However, operative rates (91% vs. 94%) and tumor resection rates (86% vs. 91%) were similar in both groups. No patient in the elderly group received chemotherapy. Death within 30 days of diagnosis was increased in the very elderly patients (11% vs. 4%). However, relative survival in the very elderly, beyond this early period, was more similar to the general population, with 50 percent surviving at least two years. While elderly patients are more likely to die from colorectal cancer than their younger counterparts, many have good relative life expectancy after surgery.
“Surgery for colon cancer can prolong life and improve quality of life for both young patients and even the ‘oldest’ of old patients,” said Glen Doherty, M.D., of the Centre for Colorectal Disease, St. Vincent’s University Hospital and lead author of the study. “When appropriate, very elderly patients should be offered an aggressive approach to treating colon cancer, including surgery.”