J W T Dekker1, G A Gooiker2, E Bastiaannet2, C B M van den Broek2, L G M van der Geest3, C J van de Velde2, R A E M Tollenaar2, G J Liefers2. 1. Leiden University Medical Center, Department of Surgery, Leiden, The Netherlands; Reinier de Graaf Gasthuis, Department of Surgery, Delft, The Netherlands. Electronic address: j.w.t.dekker@rdgg.nl. 2. Leiden University Medical Center, Department of Surgery, Leiden, The Netherlands. 3. Comprehensive Cancer Centre the Netherlands (CCCNL), Utrecht, The Netherlands.
Abstract
BACKGROUND: The 1-year mortality after colorectal cancer surgery is high and explains age related differences in colorectal cancer survival. To gain better insight in its etiology, cause of death for these patients was studied. METHODS: All 1924 patients who had a resection for stage I-III colorectal cancer from 2006 to 2008 in the Western region of the Netherlands were identified. Data were merged with cause of death data from the Central Bureau of Statistics Netherlands. To calculate excess mortality as compared to the general population, national data were used. RESULTS: Overall 13.2% of patients died within the first postoperative year. One-year mortality increased with age. It was as high as 43% in elderly patients that underwent emergency surgery. In 75% of patients, death was attributed to the colorectal cancer. In 25% of all patients, registered deaths were attributed to postoperative complications. Elderly patients with comorbidity more frequently died due to complications (p < 0.01). Death of other causes was similar to background mortality according to age group. CONCLUSION: In the presently studied cohort of patients that died within one year of surgery, cause of death was predominantly attributed to colorectal cancer. However, because it is not to be expected that in this cohort the number of deaths from recurrences is very high, the excess 1-year mortality indicates a prolonged impact of the surgery, especially in elderly patients. Therefore, in these patients we should focus on limiting the physiological impact of the surgery and be more involved in the post-hospital period.
BACKGROUND: The 1-year mortality after colorectal cancer surgery is high and explains age related differences in colorectal cancer survival. To gain better insight in its etiology, cause of death for these patients was studied. METHODS: All 1924 patients who had a resection for stage I-III colorectal cancer from 2006 to 2008 in the Western region of the Netherlands were identified. Data were merged with cause of death data from the Central Bureau of Statistics Netherlands. To calculate excess mortality as compared to the general population, national data were used. RESULTS: Overall 13.2% of patients died within the first postoperative year. One-year mortality increased with age. It was as high as 43% in elderly patients that underwent emergency surgery. In 75% of patients, death was attributed to the colorectal cancer. In 25% of all patients, registered deaths were attributed to postoperative complications. Elderly patients with comorbidity more frequently died due to complications (p < 0.01). Death of other causes was similar to background mortality according to age group. CONCLUSION: In the presently studied cohort of patients that died within one year of surgery, cause of death was predominantly attributed to colorectal cancer. However, because it is not to be expected that in this cohort the number of deaths from recurrences is very high, the excess 1-year mortality indicates a prolonged impact of the surgery, especially in elderly patients. Therefore, in these patients we should focus on limiting the physiological impact of the surgery and be more involved in the post-hospital period.
Authors: Federico Mazzotti; Alessandro Cucchetti; Yvette H M Claassen; Amanda C R K Bos; Esther Bastiaannet; Giorgio Ercolani; Jan Willem T Dekker Journal: World J Surg Date: 2019-08 Impact factor: 3.352
Authors: Yara Backes; Leon Mg Moons; Marco R Novelli; Jeroen D van Bergeijk; John N Groen; Tom Cj Seerden; Matthijs P Schwartz; Wouter H de Vos Tot Nederveen Cappel; Bernhard Wm Spanier; Joost Mj Geesing; Koen Kessels; Marjon Kerkhof; Peter D Siersema; G Johan A Offerhaus; Anya N Milne; Miangela M Lacle Journal: Mod Pathol Date: 2016-10-07 Impact factor: 7.842
Authors: Ernst J Kuipers; William M Grady; David Lieberman; Thomas Seufferlein; Joseph J Sung; Petra G Boelens; Cornelis J H van de Velde; Toshiaki Watanabe Journal: Nat Rev Dis Primers Date: 2015-11-05 Impact factor: 52.329
Authors: Max P L van der Sijp; Esther Bastiaannet; Wilma E Mesker; Lydia G M van der Geest; Anne J Breugom; Willem H Steup; Andreas W K S Marinelli; Larissa N L Tseng; Rob A E M Tollenaar; Cornelis J H van de Velde; J W T Dekker Journal: Int J Colorectal Dis Date: 2016-08-06 Impact factor: 2.571
Authors: Christopher T Aquina; Supriya G Mohile; Mohamedtaki A Tejani; Adan Z Becerra; Zhaomin Xu; Bradley J Hensley; Reza Arsalani-Zadeh; Francis P Boscoe; Maria J Schymura; Katia Noyes; John Rt Monson; Fergal J Fleming Journal: Br J Cancer Date: 2017-01-05 Impact factor: 7.640
Authors: Nicolás M González-Senac; Jennifer Mayordomo-Cava; Angela Macías-Valle; Paula Aldama-Marín; Sara Majuelos González; María Luisa Cruz Arnés; Luis M Jiménez-Gómez; María T Vidán-Astiz; José Antonio Serra-Rexach Journal: Int J Environ Res Public Health Date: 2021-06-04 Impact factor: 3.390