S H J Ketelaers1, R G Orsini1, J W A Burger1, G A P Nieuwenhuijzen1, H J T Rutten2. 1. Department of Surgery, Catharina Hospital Eindhoven, the Netherlands. 2. Department of Surgery, Catharina Hospital Eindhoven, the Netherlands; GROW: School of Oncology and Developmental Biology, University of Maastricht, Maastricht, the Netherlands. Electronic address: harm.rutten@catharinaziekenhuis.nl.
Abstract
BACKGROUND: In earlier studies an association between older patients and higher morbidity and mortality after colorectal surgery is shown, especially in the first postoperative year. We conducted this study to investigate if there is improvement in postoperative morbidity and mortality in senior CRC patients over time. MATERIALS AND METHODS: All patients, except those with distant metastasis, who received curative CRC surgery between 2006 and 2017 in the Catharina Hospital (Eindhoven, the Netherlands) were selected retrospectively. Differences in mortality and relative survival between different age groups (<75 and ≥ 75 years), period of surgery (2006-2012 and 2013-2017) and type of tumor (colon and rectum) were investigated. RESULTS: In total 2018 patients, of whom 57.4% is male, were selected (n = 1037 colon and n = 981 rectum). 615 (30.5%) patients were ≥75 years old. For electively treated CRC patients aged ≥75 years 30- and 90-day mortality improved from 5.8% to 1.2% (p = 0.004) and 9.1% to 4.6% (p = 0.043) respectively, in favour of the latest time period. Relative one-year survival rates of all electively treated CRC patients were not significantly different between younger and older patients in the latest time period (95.5% vs. 94.3%, p = n.s.). CONCLUSIONS: This study shows significant improvement in postoperative morbidity and mortality over time for both age and treatment groups. Relative survival rates improved especially for older patients and no significant differences were seen between both age groups. Senior CRC patients should not be withheld curative treatment based on age or comorbidities alone.
BACKGROUND: In earlier studies an association between older patients and higher morbidity and mortality after colorectal surgery is shown, especially in the first postoperative year. We conducted this study to investigate if there is improvement in postoperative morbidity and mortality in senior CRCpatients over time. MATERIALS AND METHODS: All patients, except those with distant metastasis, who received curative CRC surgery between 2006 and 2017 in the Catharina Hospital (Eindhoven, the Netherlands) were selected retrospectively. Differences in mortality and relative survival between different age groups (<75 and ≥ 75 years), period of surgery (2006-2012 and 2013-2017) and type of tumor (colon and rectum) were investigated. RESULTS: In total 2018 patients, of whom 57.4% is male, were selected (n = 1037 colon and n = 981 rectum). 615 (30.5%) patients were ≥75 years old. For electively treated CRCpatients aged ≥75 years 30- and 90-day mortality improved from 5.8% to 1.2% (p = 0.004) and 9.1% to 4.6% (p = 0.043) respectively, in favour of the latest time period. Relative one-year survival rates of all electively treated CRCpatients were not significantly different between younger and older patients in the latest time period (95.5% vs. 94.3%, p = n.s.). CONCLUSIONS: This study shows significant improvement in postoperative morbidity and mortality over time for both age and treatment groups. Relative survival rates improved especially for older patients and no significant differences were seen between both age groups. Senior CRCpatients should not be withheld curative treatment based on age or comorbidities alone.
Authors: Karoline B Bräuner; Andreas W Rosen; Adamantia Tsouchnika; Julie S Walbech; Mikail Gögenur; Viviane A Lin; Johan S R Clausen; Ismail Gögenur Journal: Int J Colorectal Dis Date: 2022-07-18 Impact factor: 2.796
Authors: Stijn H J Ketelaers; Anne Jacobs; An-Sofie E Verrijssen; Jeltsje S Cnossen; Irene E G van Hellemond; Geert-Jan M Creemers; Ramon-Michel Schreuder; Harm J Scholten; Jip L Tolenaar; Johanne G Bloemen; Harm J T Rutten; Jacobus W A Burger Journal: Cancers (Basel) Date: 2022-05-11 Impact factor: 6.575
Authors: Jeske R E Boeding; Winesh Ramphal; Arjen M Rijken; Rogier M P H Crolla; Cornelis Verhoef; Paul D Gobardhan; Jennifer M J Schreinemakers Journal: Ann Surg Oncol Date: 2020-10-16 Impact factor: 5.344
Authors: Petra A Custers; Barbara M Geubels; Inge L Huibregtse; Femke P Peters; Ellen G Engelhardt; Geerard L Beets; Corrie A M Marijnen; Monique E van Leerdam; Baukelien van Triest Journal: Cancers (Basel) Date: 2021-12-16 Impact factor: 6.639