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 and Methods: All consecutive octogenarians with CRC in the period of 2002 - 2008 were included. An extensive review ofhospital records was carried out. Patients were divided into two groups, as follows: group 1 included patients who were alive afterfive years of follow-up, while group 2 comprised patients who died within 5 years of their diagnosis. Cause of death was determinedand classified as related to cancer, non-related, or because of treatment.Results: Onehundredandeleven octogenarians were diagnosed withCRC(82 colon cancersand29 rectal cancers). Patients in group2 had a significantly higher disease stage compared with group 1 (P < 0.001). Patients in group 1 more often underwent surgery withcurative intent (P< 0.0001). There was no difference in clinical presentation or localization of themalignancy. In group 1, 14 patientsdied 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 asa direct consequence of CRC, 14 (22.2%) due to the treatment, and 20 (31.7%) died due to non-cancer-related causes. The overall 5-year survival rate was 40% in colon cancer patients and 51.7% in rectal cancer patients. The Charlson age co-morbidity scores weresignificantly 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 becauseof non-tumor-related disease or illness. Fit elderly people can benefit from standard therapy for CRC.