Surgery for advanced colorectal cancer in elderly patients with special emphasis for radio-chemotherapy role

Background/Aims: To compare the short- and long-term outcome of older and younger patients with advanced colorectal cancer who underwent elective surgery. Methodology: Six hundred and ninety-two patients were analyzed. Four hundred and seventy-nine patients were <70 years (group 1), and 213 were ≥70 years (group 2). Results: The overall peroperative mortality rate in younger patients was 0.8% (n=7), and 1.4% (n=3) in the elderly (p=NS); morbidity was 35% and 42%, respectively (p=NS). On univariate analysis, elderly patients had a worse overall survival (OS) compared to younger, when only patients undergoing postoperative chemo-radiotherapy were considered (54% OS vs. 67% OS at 5 years;p=0.03). Using logistic regression analysis, tumor stage (p<0.0001) and radicality of surgery (p<0.0001), were strongly associated with OS rates in the elderly. Conclusions: Colorectal surgery for malignancy can be performed safely in the elderly. Clinical trials are necessary to understand the real advantage of adjuvant or palliative treatments in these patients.