This study compared 30-day and five-year mortality in elderly vs. younger patients following surgical resection for colorectal cancer. The study examined patients admitted to veterans affairs (VA) hospitals with a new diagnosis of colorectal cancer who underwent surgical resection between October 1990 and September 2000. Cumulative survival rates (30-day and five-year) were calculated from Kaplan-Meier estimates and adjusted risks of death were estimated using Cox proportional hazards models.
The researchers identified 34,888 individuals with a new diagnosis of colorectal cancer between October 1990 and September 2000, of whom 22,633 (65%) underwent surgical resection. The 30-day mortality following resection for rectal and colon cancer, respectively, for patients less than 65 years of age was 2.1% and 2.8% compared with 4.9% and 5.6% for those 65 years of age or older. The 5-year cumulative survival for rectal and colon cancer for patients less than 65 years of age was 54.0% and 57.6% compared with 44.5% and 46.6% for those 65 years of age or older. In patients 65 years of age or older with rectal or colon cancer, after adjustment, the 30-day mortality was 2.5 times greater and five-year mortality was 1.5 times greater than in younger patients.
The study concludes that older age is an independent predictor of increased short-term and long-term mortality following surgery in patients with rectal and colon cancer.