Factors favoring survival in elderly patients with colorectal cancer

Jung, Ji Min; Jung, Sung Ae; Kim, Seong Eun; Kang, Min Jung; Shim, Ki Nam; Kim, Kwang Ho; Yoo, Kwon; Moon, Il Hwan

Abstract

BACKGROUND/AIMS: Colorectal cancer occurs predominantly in the elderly, and whether to operate on these patients is a dilemma. This study compared clinical parameters and evaluated factors favoring survival in elderly patients with colorectal cancer according to the treatment modality.
METHODS
The study evaluated 213 patients who were older than 75 years and diagnosed with colorectal cancer between 1995 and 2005. Survival rate and clinical parameters were compared between the surgical and conservative treatment groups. Demographics, underlying conditions, and cancer and treatment-related factors were evaluated for survival using multivariate analysis in the conservatively treated patients and separately in the surgery group.
RESULTS
The surgery group consisted of 143 (67.1%) patients and the conservative group consisted of 70 (32.9%) patients. Fewer patients had a high ASA class in the surgery group than in the conservative group (p<0.05). The survival rate in the surgery group was higher than in the conservative group (p<0.05) even when compared for the same cancer stage, ASA class, and age (p<0.05). In the surgery group, the absence of history of diabetes mellitus, lower cancer stage, elective surgery, and curative surgery all favored survival (p<0.05).
CONCLUSIONS
The 5-year survival rate in the surgery group was higher than that in the conservative group. Surgery is recommended for elderly patients with colorectal cancer who are in good physical shape and have a lower stage, a resectable tumor, and a non-emergency condition