Colorectal Cancer in Octogenarians: Results of Treatment, a Descriptive Clinical Study

Abstract

Background: Colorectal cancers (CRCs) often occur in octogenarians. However, data on treatment and survival are sparse. Objectives: Octogenarians were studied in order to gain data on treatment, outcomes, and survival related to CRC. Patients andMethods: All consecutive octogenarians with CRC in the period of 2002 2008 were included. An extensive review of hospital records was carried out. Patients were divided into two groups, as follows: group 1 included patients who were alive after five years of follow-up, while group 2 comprised patients who died within 5 years of their diagnosis. Cause of death was determined and classified as related to cancer, non-related, or because of treatment. Results: One hundred and eleven octogenarians were diagnosed with CRC (82 colon cancers and 29 rectal cancers). Patients in group 2 had a significantly higher disease stage compared with group 1 (P < 0.001). Patients in group 1 more often underwent surgery with curative intent (P < 0.0001). There was no difference in clinical presentation or localization of the malignancy. In group 1, 14 patients died more than 5 years after surgery. The cause of death was not related to cancer in 100% of cases. In group 2, 29 (46.0%) died as a direct consequence of CRC, 14 (22.2%) due to the treatment, and 20 (31.7%) died due to non-cancer-related causes. The overall 5year survival rate was 40% in colon cancer patients and 51.7% in rectal cancer patients. The Charlson age co-morbidity scores were significantly lower in colon cancer patients in group 1 (P = 0.005). This was not the case in patients with rectal cancer. Conclusions: The co-morbidity score is important in survival after surgery. Forty-four percent of octogenarians with CRC died because of non-tumor-related disease or illness. Fit elderly people can benefit from standard therapy for CRC.