Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 7, 2009; 15(45): 5706-5711
Published online Dec 7, 2009. doi: 10.3748/wjg.15.5706
Impact of age-related comorbidity on results of colorectal cancer surgery
Corrado Pedrazzani, Guido Cerullo, Giovanni De Marco, Daniele Marrelli, Alessandro Neri, Alfonso De Stefano, Enrico Pinto, Franco Roviello
Corrado Pedrazzani, Guido Cerullo, Giovanni De Marco, Daniele Marrelli, Alessandro Neri, Alfonso De Stefano, Enrico Pinto, Franco Roviello, Department of Human Pathology and Oncology, Unit of Surgical Oncology, University of Siena, 53100 Siena, Italy
Author contributions: Pedrazzani C and Cerullo G contributed equally; Pedrazzani C and Cerullo G provided study concept and design; Cerullo G and De Marco G collected data; Pedrazzani C, Cerullo G and Marrelli D performed data analysis and interpretation; Pedrazzani C, Cerullo G and De Marco G drafted the manuscript; Pedrazzani C, Marrelli D, Neri A and Roviello F provided critical revision of the paper; De Stefano A and Pinto E obtained funding and material support.
Correspondence to: Dr. Corrado Pedrazzani, Department of Human Pathology and Oncology, Unit of Surgical Oncology, University of Siena, Policlinico Le Scotte, 53100 Siena, Italy. pedrazzani@unisi.it
Telephone: +39-577-585156 Fax: +39-577-233337
Received: May 15, 2009
Revised: October 17, 2009
Accepted: October 24, 2009
Published online: December 7, 2009
Abstract

AIM: To analyze the correlation between preexisting comorbidity and other clinicopathological features, short-term surgical outcome and long-term survival in elderly patients with colorectal cancer (CRC).

METHODS: According to age, 403 patients operated on for CRC in our department were divided into group A (< 70 years old) and group B (≥ 70 years old) and analyzed statistically.

RESULTS: Rectal localization prevailed in group A (31.6% vs 19.7%, P = 0.027), whereas the percentage of R0 resections was 77% in the two groups. Comorbidity rate was 46.2% and 69.1% for group A and B, respectively (P < 0.001), with a huge difference as regards cardiovascular diseases. Overall, postoperative morbidity was 16.9% and 20.8% in group A and B, respectively (P = 0.367), whereas mortality was limited to group B (4.5%, P = 0.001). In both groups, patients who suffered from postoperative complications had a higher overall comorbidity rate, with preexisting cardiovascular diseases prevailing in group B (P = 0.003). Overall 5-year survival rate was significantly better for group A (75.2% vs 55%, P = 0.006), whereas no significant difference was observed considering disease-specific survival (76.3% vs 76.9%, P = 0.674).

CONCLUSION: In spite of an increase in postoperative mortality and a lower overall long-term survival for patients aged ≥ 70 years old, it should be considered that, even in the elderly group, a significant number of patients is alive 5 years after CRC resection.

Keywords: Colorectal cancer; Elderly; Post-operative complications; Co-morbidity; Aged