The University of Southampton
University of Southampton Institutional Repository

Surgery for colorectal cancer in elderly patients: a systematic review.

Surgery for colorectal cancer in elderly patients: a systematic review.
Surgery for colorectal cancer in elderly patients: a systematic review.
Background: the effectiveness of surgery for colorectal cancer depends on it being carried out safely, which allows most patients to return to productive lives, with an improved postoperative life expectancy, or at least one that is not diminished by the surgery. Because colorectal cancer is a major cause of morbidity and mortality in elderly people, we have examined how the outcomes of surgery in elderly patients differ from those in younger patients.

Methods: we did a systematic review of published and aggregate data provided by investigators. Studies were identified by computerised and manual searches of published and unpublished reports, scanning references, and contacting investigators. Within each study, outcomes for patients aged 65–74 years, 75–84 years, and 85+ years were expressed in relation to those aged less than 65 years.

Findings: from 28 independent studies, and a total of 34194 patients, we found that elderly patients had an increased frequency of comorbid conditions, were more likely to present with later-stage disease and undergo emergency surgery, and less likely to have curative surgery than younger patients. The incidence of postoperative morbidity and mortality increased progressively with advancing age. Overall survival was reduced in elderly patients, but for cancer specific survival age-related differences were much less striking.

Interpretation: the relation between age and outcomes from colorectal cancer surgery is complex and may be confounded by differences in stage at presentation, tumour site, pre-existing comorbidities, and type of treatment received. However, selected elderly patients benefit from surgery since a large proportion survive for 2 or more years, irrespective of their age.
0140-6736
968-974
Simmonds, P.D.
27d4c068-e352-4cbf-9899-771893788ade
Best, Lesley
7c4a1fe5-21a1-4634-a1cc-0230322603d1
George, S.
b035660d-4501-4592-bdd8-aedaa7ecfbe7
Baughan, C.
b8f0b39a-a0f1-4090-a319-dce0f187cae8
Buchanan, R.
bb13d095-ca2c-4099-9426-c2c9857cb96e
Davis, C.
429c5c88-c63a-428c-8393-d98fc5fbad60
Fentiman, I.
195dc0d9-057f-4168-ae9a-e903e6e8a391
Gosney, M.
981f6225-6203-4316-b6a2-92afd5d8f40d
Northover, J.
5c9277b2-20b1-4bad-8043-d60c78567960
Williams, C.
382b26c3-2135-4e96-ae1d-4c6da642ce6a
Colorectal Cancer Collaborative Group
Simmonds, P.D.
27d4c068-e352-4cbf-9899-771893788ade
Best, Lesley
7c4a1fe5-21a1-4634-a1cc-0230322603d1
George, S.
b035660d-4501-4592-bdd8-aedaa7ecfbe7
Baughan, C.
b8f0b39a-a0f1-4090-a319-dce0f187cae8
Buchanan, R.
bb13d095-ca2c-4099-9426-c2c9857cb96e
Davis, C.
429c5c88-c63a-428c-8393-d98fc5fbad60
Fentiman, I.
195dc0d9-057f-4168-ae9a-e903e6e8a391
Gosney, M.
981f6225-6203-4316-b6a2-92afd5d8f40d
Northover, J.
5c9277b2-20b1-4bad-8043-d60c78567960
Williams, C.
382b26c3-2135-4e96-ae1d-4c6da642ce6a

Colorectal Cancer Collaborative Group (2000) Surgery for colorectal cancer in elderly patients: a systematic review. The Lancet, 356 (9234), 968-974. (doi:10.1016/S0140-6736(00)02713-6).

Record type: Article

Abstract

Background: the effectiveness of surgery for colorectal cancer depends on it being carried out safely, which allows most patients to return to productive lives, with an improved postoperative life expectancy, or at least one that is not diminished by the surgery. Because colorectal cancer is a major cause of morbidity and mortality in elderly people, we have examined how the outcomes of surgery in elderly patients differ from those in younger patients.

Methods: we did a systematic review of published and aggregate data provided by investigators. Studies were identified by computerised and manual searches of published and unpublished reports, scanning references, and contacting investigators. Within each study, outcomes for patients aged 65–74 years, 75–84 years, and 85+ years were expressed in relation to those aged less than 65 years.

Findings: from 28 independent studies, and a total of 34194 patients, we found that elderly patients had an increased frequency of comorbid conditions, were more likely to present with later-stage disease and undergo emergency surgery, and less likely to have curative surgery than younger patients. The incidence of postoperative morbidity and mortality increased progressively with advancing age. Overall survival was reduced in elderly patients, but for cancer specific survival age-related differences were much less striking.

Interpretation: the relation between age and outcomes from colorectal cancer surgery is complex and may be confounded by differences in stage at presentation, tumour site, pre-existing comorbidities, and type of treatment received. However, selected elderly patients benefit from surgery since a large proportion survive for 2 or more years, irrespective of their age.

This record has no associated files available for download.

More information

Published date: 16 September 2000

Identifiers

Local EPrints ID: 485578
URI: http://eprints.soton.ac.uk/id/eprint/485578
ISSN: 0140-6736
PURE UUID: 76d7eb75-4d3b-4af6-b708-8e60e42f423c
ORCID for Lesley Best: ORCID iD orcid.org/0000-0003-1489-3471

Catalogue record

Date deposited: 11 Dec 2023 17:35
Last modified: 16 Aug 2024 01:59

Export record

Altmetrics

Contributors

Author: P.D. Simmonds
Author: Lesley Best ORCID iD
Author: S. George
Author: C. Baughan
Author: R. Buchanan
Author: C. Davis
Author: I. Fentiman
Author: M. Gosney
Author: J. Northover
Author: C. Williams
Corporate Author: Colorectal Cancer Collaborative Group

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×