Although patients ≥75 years of age presenting as a colorectal cancer emergency are less likely to undergo emergency curative surgery, survival rates after surgery are similar to that seen in younger patients, according to a study by the Department of Colorectal Surgery at York Teaching Hospital.
The single centre retrospective study reviewed colorectal cancer emergencies presenting between 1 April 2007 and 1 April 2017 and separated patients into two cohorts: young (<75 years) and elderly (≥75 years).
A total of 341 patients (<75 yrs: n=154; ≥75 yrs: n=187) presented as a colorectal cancer emergency. Significantly fewer elderly patients underwent curative surgical procedures (72% vs 49%; P<0.0001) or received adjuvant chemotherapy (56% vs 21%; P<0.0001).
Elderly patients had significantly more postoperative cardiorespiratory complications (7% vs 36%; P<0.0001). Despite this there was no significant difference in 30-day mortality (7% vs 12%,), one-year survival rates (75% vs 74%), or three-year survival (56% vs 49%). Elderly patients treated with best supportive care had a median overall survival of just 62 days (range 1-955).
The findings suggest more consideration should be given to performing emergency curative surgery on elderly patients presenting with colorectal cancer emergency.
