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Authors Neuman HB, O'Connor ES, Weiss J, LoConte NK, Greenblatt DY, Smith M
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Journal J. Clin. Oncol. Volume: 29 Issue: 15_suppl Pages: 6071
Publish Date 2011 May 20
PubMed ID 28021795
Abstract

6071 Background: Individuals >80 years represent a growing proportion of colon cancer patients and create a decision-making challenge for surgeons due to frequent comorbidities. Our objective was to describe patterns of surgery in colon cancer patients >80 years and examine outcomes with and without colectomy.Medicare beneficiaries >80 years with colon cancer diagnosed from 1992-2005 were identified from the Surveillance, Epidemiology, and End Results-Medicare database; stage IV was excluded. χ(2) and two-way ANOVA assessed differences in patient characteristics. Kaplan-Meier survival analysis determined one-year overall and disease-specific survival.Of 35,080 patients, 80% underwent colectomy within 90 days of diagnosis. 46% were for urgent/emergent reasons. Post-operative complications occurred in 4%, and 9% died within 30 days. Patients not selected for colectomy had more comorbidities (higher HCC risk score), were more likely to have a wheelchair and use home oxygen (Table). 11% of these non-operative patients ultimately required a cancer-related intervention (delayed colectomy 9%, stoma 1.4%, stent 0.4%). One-year overall survival with and without colectomy was 77 vs. 58%. One-year disease-specific survival was 89 vs. 76%.Most older colon cancer patients undergo colectomy, although many for urgent/emergent reasons. Disease-specific survival after colectomy is greater than overall survival, confirming that many die due to competing causes. Further research should focus on improving mechanisms to identify those patients >80 years at increased risk for a poor outcome after elective colectomy. [Table: see text].

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