Long-term survival following elective colon cancer surgery in the aged. A population-based cohort study

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Niemeläinen , S , Huhtala , H , Ehrlich , A , Kössi , J , Jämsen , E & Hyöty , M 2020 , ' Long-term survival following elective colon cancer surgery in the aged. A population-based cohort study ' , Colorectal Disease , vol. 22 , no. 11 , pp. 1597-1602 . https://doi.org/10.1111/codi.15242

Title: Long-term survival following elective colon cancer surgery in the aged. A population-based cohort study
Author: Niemeläinen, S.; Huhtala, H.; Ehrlich, A.; Kössi, J.; Jämsen, E.; Hyöty, M.
Contributor organization: HYKS erva
Päijät-Häme Welfare Consortium
Date: 2020-11
Language: eng
Number of pages: 6
Belongs to series: Colorectal Disease
ISSN: 1462-8910
DOI: https://doi.org/10.1111/codi.15242
URI: http://hdl.handle.net/10138/322653
Abstract: Aim The number of colorectal cancer patients increases with age. Long-term data support personalized management due to heterogeneity within the older population. This registry- and population-based study aimed to analyse long-term survival, and causes of death, after elective colon cancer surgery in the aged, focusing on patients who survived more than 3 months postoperatively. Methods The data included patients >= 80 years who had elective surgery for Stage I-III colon cancer in four Finnish centres. The prospectively collected data included comorbidities, functional status, postoperative outcomes and long-term survival. Univariate and multivariate Cox regression analysis were conducted to determine factors associated with long-term survival. Results A total of 386 surgical patients were included, of whom 357 survived over 3 months. Survival rates for all patients at 1, 3 and 5 years were 85%, 66% and 55%, compared to 92%, 71% and 59% for patients alive 3 months postoperatively, respectively. Higher age, American Society of Anesthesiologists (ASA) score >= 4, Charlson Comorbidity Index >= 6, tumour Stage III, open compared to laparoscopic surgery and severe postoperative complications were independently associated with reduced overall survival. Higher age (hazard ratio 1.97, 1.14-3.40), diabetes (1.56, 1.07-2.27), ASA score >= 4 (3.27, 1.53-6.99) and tumour Stage III (2.04, 1.48-2.81) were the patient-related variables affecting survival amongst those surviving more than 3 months postoperatively. Median survival time for patients given adjuvant chemotherapy was 5.4 years, compared to 3.3 years for patients not given postoperative treatment. Conclusions Fit aged colon cancer patients can achieve good long-term outcomes and survival with radical, minimally invasive surgical treatment, even with additional chemotherapy.
Subject: Colon cancer
aged patients
long-term outcome
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion

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