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Should we resect colorectal cancer in patients over the age of 85?
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  • David Flynn,
  • Derek Mao,
  • Stephanie Yerkovich,
  • Robert Franz,
  • Harish Iswariah,
  • Andrew Hughes,
  • Ian Shaw,
  • Diana Tam,
  • Manju Chandrasegaram
David Flynn
The Prince Charles Hospital
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Derek Mao
The Prince Charles Hospital
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Stephanie Yerkovich
The Prince Charles Hospital
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Robert Franz
The Prince Charles Hospital
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Harish Iswariah
The Prince Charles Hospital
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Andrew Hughes
The Prince Charles Hospital
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Ian Shaw
The Prince Charles Hospital
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Diana Tam
The Prince Charles Hospital
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Manju Chandrasegaram
The Prince Charles Hospital
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Abstract

Rationale, aims and objective The prevalence of colorectal cancer in the elderly is increasing with older patients undergoing surgery. The aim of the study was two-fold: to evaluate the post-operative outcomes for patients ≥ 85 years old following colorectal cancer resection as well as evaluating the outcomes of laparoscopic resection of colorectal cancer in patients over 85. Methods The study was divided into two parts. For part one, patients were divided into two groups based on age: those age ≥ 85 years old and those aged 75-84 years old. Short term surgical outcomes and clinicopathological features were compared using appropriate parametric and non-parametric testing. For part two, patient’s over 85 years old were divided into two groups based upon operative technique: laparoscopic vs open colorectal resection. Short-term post-operative outcomes of each approach were assessed. Results The median length of stay (LOS) between patients over 85 and those aged 75-85 was eight days, with no statistically significant difference in LOS between the groups (p=0.29). No significant difference was identified between the older and younger groups with regards to severity of complications (p=0.93), ASA grading (p=0.43) or 30-day mortality (2 vs 2%, p= p=0.96). Patients over 85 who underwent laparoscopic colorectal resection were compared to those who underwent an open resection. The median length of stay between the group was similar (8 vs 9 days respectively) with no significant difference in length of stay (p=0.18). There was no significant difference in 30-day mortality rates (0% vs 9%, p=0.063) or severity of complication grades (p=0.46) between the laparoscopic and open surgical groups. Conclusion No significant short term surgical differences were identified in patients ≥ 85 years old when compared to those 75-85 years old. There is no difference in short term surgical outcomes between laparoscopic or open colorectal resections in patients over 85.

Peer review status:Published

15 Mar 2021Published in World Journal of Gastrointestinal Oncology volume 13 issue 3 on pages 185-196. 10.4251/wjgo.v13.i3.185