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World J Gastrointest Surg. Sep 27, 2016; 8(9): 606-613
Published online Sep 27, 2016. doi: 10.4240/wjgs.v8.i9.606
Role of surgery for colorectal cancer in the elderly
Antonio Biondi, Marco Vacante, Immacolata Ambrosino, Erika Cristaldi, Giuseppe Pietrapertosa, Francesco Basile
Antonio Biondi, Francesco Basile, Department of Surgery, Vittorio Emanuele Hospital, University of Catania, 95100 Catania, Italy
Marco Vacante, Erika Cristaldi, Department of Medical and Pediatric Sciences, University of Catania, 95100 Catania, Italy
Immacolata Ambrosino, Giuseppe Pietrapertosa, Community Hospital Service ULSS 20 Verona, 37122 Verona, Italy
Author contributions: All authors wrote and critically revised the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Antonio Biondi, MD, PhD, Associate Professor, Department of Surgery, Vittorio Emanuele Hospital, University of Catania, Via Plebiscito 628, 95100 Catania, Italy. abiondi@unict.it
Telephone: +39-95-7435373
Received: March 25, 2016
Peer-review started: March 25, 2016
First decision: May 23, 2016
Revised: June 15, 2016
Accepted: July 14, 2016
Article in press: July 18, 2016
Published online: September 27, 2016
Processing time: 184 Days and 14.4 Hours
Abstract

The prevalence of subjects with colorectal cancer is expected to grow in the next future decades and surgery represents the most successful treatment modality for these patients. Anyway, currently elderly subjects undergo less elective surgical procedures than younger patients mainly due to the high rates of postoperative morbidity and mortality. Some authors suggest extensive surgery, including multistage procedures, as carried out in younger patients while others promote less aggressive surgery. In older patients, laparoscopic-assisted colectomy showed a number of advantages compared to conventional open surgery that include lower stress, higher rate of independency after surgery, quicker return to prior activities and a decrease in costs. The recent advances in chemotherapy and the introduction of new surgical procedures such as the endoluminal stenting, suggest the need for a revisitation of surgical practice patterns and the role of palliative surgery, mainly for patients with advanced disease. In this article, we discuss the current role of surgery for elderly patients with colorectal cancer.

Keywords: Laparoscopy; Colorectal cancer; Elderly; Comorbidities; Colorectal surgery

Core tip: Age itself should not be considered as a risk factor for the development of complications in patients undergoing surgery for colorectal cancer. Many studies underlined that age is not a predictor of post operative complications in these patients. Therapeutic or palliative surgery should not be avoided in the elderly based exclusively on age.