Prognosis of elderly patients with large bowel cancer

The effect of age on the presentation, diagnosis, management and survival of patients with colorectal cancer was studied prospectively in 512 patients admitted to a single institution. In all, 225 patients were aged 70 years or more and 287 less than 70 years. Older patients had a significant excess of emergency presentations (18 versus 11 per cent). Methods of diagnosis, proportion of curative operations performed, stage and histological grade were similar in the two age groups. The postoperative mortality rate was 6 per cent in the elderly group and 3 per cent in younger patients. The postoperative mortality rate rose to 15 and 12 per cent respectively in those undergoing emergency surgery. The relative 5‐year survival rate standardized for age and sex was 52 per cent for older patients and 45 per cent for younger patients; for those undergoing curative surgery it was 68 and 59 per cent respectively. The behaviour of colorectal carcinoma changes little with age and, allowing for population mortality, age has no effect on the long‐term survival of elderly patients with large bowel cancer.

[1]  J. Cuzick,et al.  Prevention of colorectal cancer by once-only sigmoidoscopy , 1993, The Lancet.

[2]  J. Macfarlane,et al.  Mesorectal excision for rectal cancer , 1993, The Lancet.

[3]  P. Greenwald Colon cancer overview , 1992, Cancer.

[4]  W. Meyers,et al.  Effective surgical adjuvant therapy for high-risk rectal carcinoma. , 1991, The New England journal of medicine.

[5]  P. Schlag,et al.  Endorectal ultrasonography for the assessment of invasion of rectal tumours and lymph node involvement , 1990, The British journal of surgery.

[6]  E. Guadagnoli,et al.  The influence of patient age on the diagnosis and treatment of lung and colorectal cancer. , 1990, Archives of internal medicine.

[7]  G. Carlon,et al.  Age and utilization of intensive care unit resources of critically ill cancer patients. , 1990, Critical care medicine.

[8]  I. Fentiman,et al.  Cancer in the elderly: why so badly treated? , 1990, The Lancet.

[9]  T R Fleming,et al.  Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. , 1990, The New England journal of medicine.

[10]  L. Fielding,et al.  FACTORS INFLUENCING MORTALITY AFTER CURATIVE RESECTION FOR LARGE BOWEL CANCER IN ELDERLY PATIENTS , 1989, The Lancet.

[11]  J. Virjee,et al.  Preoperative assessment of mesorectal lymph node involvement in rectal cancer , 1989, The British journal of surgery.

[12]  T. Irvin,et al.  Prognosis of colorectal cancer in the elderly , 1988, The British journal of surgery.

[13]  J W Arends,et al.  Regression analysis of prognostic factors in colorectal cancer after curative resections , 1988, Diseases of the Colon & Rectum.

[14]  Ershler Wb The change in aggressiveness of neoplasms with age. , 1987 .

[15]  T. Bader,et al.  Colorectal cancer in patients older than 75 years of age , 1986, Diseases of the colon and rectum.

[16]  P. Chapuis,et al.  Surgery for large bowel cancer in people aged 75 years and older , 1986, Diseases of the colon and rectum.

[17]  J. Samet,et al.  Choice of cancer therapy varies with age of patient. , 1986, JAMA.

[18]  J. Drumm,et al.  Emergency presentation and mortality from colorectal cancer in the elderly , 1986, The British journal of surgery.

[19]  A. Greenburg,et al.  Influence of age on mortality of colon surgery. , 1985, American journal of surgery.

[20]  J. B. Simon Occult blood screening for colorectal carcinoma: a critical review. , 1985, Gastroenterology.

[21]  R. Williamson,et al.  Survival of 727 patients with single carcinomas of the large bowel , 1984, Diseases of the colon and rectum.

[22]  M. Pathy,et al.  Colorectal carcinoma in the elderly: a geriatric and surgical practice compared. , 1983, Age and ageing.

[23]  E. Rosato,et al.  Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. , 1980, Annals of surgery.

[24]  Daniel G. Miller On the nature of susceptibility to cancer. The presidential address , 1980, Cancer.

[25]  L. R. Guercio,et al.  Monitoring Operative Risk in the Elderly , 1980 .

[26]  J. Hedley-Whyte,et al.  Prediction of outcome of surgery and anesthesia in patients over 80. , 1979, JAMA.

[27]  M. Pike,et al.  Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. , 1977, British Journal of Cancer.

[28]  I. Balslev,et al.  Crcinoma of the Colon in Old Age , 1970, Annals of surgery.

[29]  D. Schottenfeld,et al.  Adjustment of long-term survival rates for deaths due to intercurrent disease. , 1969, Journal of chronic diseases.

[30]  F. R. Watson,et al.  Cancer of the colon: the influence of the no-touch isolation technic on survival rates. , 1967, Annals of surgery.

[31]  C. Dukes,et al.  The classification of cancer of the rectum , 1980 .