Type and Consequences of Short-Term Complications in Colon Cancer Surgery, Focusing on The Oldest Old

Abstract Background While the proportion of colon cancer occurring in older patients is expected to increase, these patients may have more complications that may lead to serious consequences. The aim of this study was assess postoperative complications and their short-term consequences in colon cancer surgery according to age. Materials and Methods Patients undergoing surgery for primary invasive colon cancer in 22 centres between June 2010 and December 2012 were included. Pre-surgical and surgical variables were analysed, and in-hospital major postoperative complications and its most serious consequence (no relevant, transfusion, re-intervention, admission to the intensive care unit, or death) were estimated, according to age groups. Chi-square tests were used to analyse the possible associations between variables and age groups. Results 1976 patients (a mean age 68 years (range 24-97); 62% men) were analyzed, of whom 52.2% aged > 69 y and 17.7% aged > 79 y. Complication rate was 23.5%, reaching 31% in those aged ≥ 80 y. Older age was associated with a higher rate of postoperative infections during the hospital stay. The most common surgical complication in patients aged > 85 y was dehiscence of the anastomosis (11.5%). About 5% of patients with major complications died in hospital (11.1% of aged 80-84 y and 14.3% of aged > 85 y). Among patients aged > 85 y, 38.1% required transfusions. Conclusion Older patients should receive appropriate functional preparation before the intervention, and when the risks of the intervention outweigh the potential benefits, a nonsurgical approach may be preferable.