Author:
Høydahl Øystein,Edna Tom-Harald,Xanthoulis Athanasios,Lydersen Stian,Endreseth Birger Henning
Abstract
Abstract
Background
Few studies have addressed colon cancer surgery outcomes in an unselected cohort of octogenarian patients. The present study aimed to evaluate the relative survival of octogenarian patients after a major resection of colon cancer with a curative intent.
Methods
All patients diagnosed with colon cancer at Levanger Hospital between 1980 and 2016 were included. We performed logistic regression to test for associations between 90-day mortality and explanatory variables. We performed a relative survival analysis to identify factors associated with short- and long-term survival.
Results
Among 237 octogenarian patients treated with major resections with curative intent, the 90-day mortality was 9.3%. Among 215 patients that survived the first 90 days, the 5 year relative survival rate was 98.7%. The 90-day mortality of octogenarian patients was significantly higher than that of younger patients, but the long-term survival converged with that of younger patients. Among octogenarian patients, the incidence of colon cancer more than doubled during our 37-year observation period. The relative increase in patients undergoing surgery exceeded the increase in incidence; hence, more patients were selected for surgery over time. A high 90-day mortality was associated with older age, a high American Society of Anaesthesiologists (ASA) score, and emergency surgery. Moreover, worse long-term survival was associated with a high Charlson Comorbidity Index, a high ASA score, a worse TNM stage, emergency surgery and residual tumours. Both the 90-day and long-term survival rates improved over time.
Conclusion
Among octogenarian patients with colon cancer that underwent major resections with curative intent, the 90-day mortality was high, but after surviving 90 days, the relative long-term survival rate was comparable to that of younger patients. Further improvements in survival will primarily require measures to reduce the 90-day mortality risk.
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
Reference54 articles.
1. Danckert B FJ EG, Hansen HL, Johannesen TB, Khan S, Køtlum JE, Ólafsdóttir E, Schmidt LKH, Virtanen A, Storm HH. NORDCAN: Cancer Incidence, Mortality, Prevalence and Survival in the Nordic Countries, Version 82 (26032019) Association of the Nordic Cancer Registries Danish Cancer Society. http://www-depiarcfr/NORDCAN/NO/frameasp.
2. Norwegian Institute of Public Health (NIPH). Public Health Report - Health Status in Norway 2018. 2018.
3. Kunitake H, Zingmond DS, Ryoo J, Ko CY. Caring for octogenarian and nonagenarian patients with colorectal cancer: what should our standards and expectations be? Dis Colon Rectum. 2010;53(5):735–43. https://doi.org/10.1007/DCR.0b013e3181cdd658.
4. Hoydahl O, Edna TH, Xanthoulis A, Lydersen S, Endreseth BH. Long-term trends in colorectal cancer: incidence, localization, and presentation. BMC Cancer. 2020;20(1):1077. https://doi.org/10.1186/s12885-020-07582-x.
5. Helsedirektoratet. Nasjonalt handlingsprogram med retningslinjer for diagnostikk, behandling og oppfølging av kreft i tykktarm og endetarm. 2019.
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