Y H M Claassen1, E Bastiaannet2, E van Eycken3, N Van Damme3, A Martling4, R Johansson5, L H Iversen6, P Ingeholm7, V E P P Lemmens8, G J Liefers9, F A Holman9, J W T Dekker10, J E A Portielje11, H J Rutten12, C J H van de Velde13. 1. Department of Surgical Oncology, Leiden University Medical Center, the Netherlands. Electronic address: y.h.m.claassen@lumc.nl. 2. Department of Surgical Oncology, Leiden University Medical Center, the Netherlands; Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands. 3. National Cancer Registry, Brussels, Belgium. 4. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 5. Department of Radiation Science, Oncology, Umeå University, Umeå, Sweden. 6. Department of Surgery, Aarhus University Hospital, Aarhus, Denmark; Danish Colorectal Cancer Group (DCCG.dk), Copenhagen, Denmark. 7. Department of Pathology, Herlev and Gentofte Hospital, Copenhagen, Denmark. 8. Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Department of Public Health, Erasmus MC, Rotterdam, the Netherlands. 9. Department of Surgical Oncology, Leiden University Medical Center, the Netherlands. 10. Department of Surgery, Reinier de Graaf Hospital, Delft, the Netherlands. 11. Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands. 12. Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands; GROW: School of Oncology and Developmental Biology, University of Maastricht, Maastricht, the Netherlands. 13. Department of Surgical Oncology, Leiden University Medical Center, the Netherlands. Electronic address: C.J.H.van_de_Velde@lumc.nl.
Abstract
BACKGROUND: Decreased cancer specific survival in older colorectal patients is mainly due to mortality in the first year, emphasizing the importance of the first postoperative year. This study aims to gain an overview and time trends of short-term mortality in octogenarians (≥80 years) with colorectal cancer across four North European countries. METHODS: Patients of 80 years or older, operated for colorectal cancer (stage I-III) between 2005 and 2014, were included. Population-based cohorts from Belgium, Denmark, the Netherlands, and Sweden were collected. Separately for colon- and rectal cancer, 30-day, 90-day, one-year, and excess one-year mortality were calculated. Also, short-term mortality over three time periods (2005-2008, 2009-2011, 2012-2014) was analyzed. RESULTS: In total, 35,158 colon cancer patients and 10,144 rectal cancer patients were included. For colon cancer, 90-day mortality rate was highest in Denmark (15%) and lowest in Sweden (8%). For rectal cancer, 90-day mortality rate was highest in Belgium (11%) and lowest in Sweden (7%). One-year excess mortality rate of colon cancer patients decreased from 2005 to 2008 to 2012-2014 for all countries (Belgium: 17%-11%, Denmark: 21%-15%, the Netherlands: 18%-10%, and Sweden: 10%-8%). For rectal cancer, from 2005 to 2008 to 2012-2014 one-year excess mortality rate decreased in the Netherlands from 16% to 7% and Sweden: 8%-2%). CONCLUSIONS: Short-term mortality rates were high in octogenarians operated for colorectal cancer. Short-term mortality rates differ across four North European countries, but decreased over time for both colon and rectal cancer patients in all countries.
BACKGROUND:Decreased cancer specific survival in older colorectalpatients is mainly due to mortality in the first year, emphasizing the importance of the first postoperative year. This study aims to gain an overview and time trends of short-term mortality in octogenarians (≥80 years) with colorectal cancer across four North European countries. METHODS:Patients of 80 years or older, operated for colorectal cancer (stage I-III) between 2005 and 2014, were included. Population-based cohorts from Belgium, Denmark, the Netherlands, and Sweden were collected. Separately for colon- and rectal cancer, 30-day, 90-day, one-year, and excess one-year mortality were calculated. Also, short-term mortality over three time periods (2005-2008, 2009-2011, 2012-2014) was analyzed. RESULTS: In total, 35,158 colon cancerpatients and 10,144 rectal cancerpatients were included. For colon cancer, 90-day mortality rate was highest in Denmark (15%) and lowest in Sweden (8%). For rectal cancer, 90-day mortality rate was highest in Belgium (11%) and lowest in Sweden (7%). One-year excess mortality rate of colon cancerpatients decreased from 2005 to 2008 to 2012-2014 for all countries (Belgium: 17%-11%, Denmark: 21%-15%, the Netherlands: 18%-10%, and Sweden: 10%-8%). For rectal cancer, from 2005 to 2008 to 2012-2014 one-year excess mortality rate decreased in the Netherlands from 16% to 7% and Sweden: 8%-2%). CONCLUSIONS: Short-term mortality rates were high in octogenarians operated for colorectal cancer. Short-term mortality rates differ across four North European countries, but decreased over time for both colon and rectal cancerpatients in all countries.