Clinical Studies of Colorectal Cancer in the Aged Patients

Yuichi Machiki, Hirotoshi Ohta, Kaoru Azekura, Makoto Seki, Masashi Ueno, Mitsumasa Nishi, Yo Katoh*

Department of Surgery, Cancer Institute Hospital
*Department of Pathology, Cancer Institute

Nine hundred seventeen patients who underwent surgery for colorectal cancer during 1976-1985 at Cancer Institute Hospital were studied retrospectively to compare the clinicopathological features and operative risks in 114 aged greater than or equal to 75 (GE75) and 803 less than 75 (LT75). There was no significant difference in the rate of curative resection between GE75 and LT75. The clinicopathological study revealed that the colorectal cancer in GE75 had a higher grade of malignancy. Cancer invasion to neighboring organs was more frequently observed in GE75 (p<0.01). Lymph node metastasis and peritoneal dissemination tend to be more frequent, and clinical stage also to be more advanced in GE75. Thus, there was statistically significant difference in 5-year cumulative survival rates between GE75 and LT75 (p<0.001), in spite of the fact that the analysis excluded patients who died of other diseases or died within a month. The evaluation of operative risk revealed higher in GE75. A statistically significant difference was observed in frequency of postoperative death within a month and postoperative complications, especially respiratory dysfunction and multiple organ failure between GE75 and LT75 (p<0.01). Cardiovascular, pulmonary and renal dysfunction estimated preoperatively were significantly observed in GE75 (p<0.01). There was good correlation between these preoperative assessment and rate of postoperative death within a month. The operative indication for colorectal cancer in GE75 should be the same as those for any younger group. Careful preoperative assessment of cancer grade and operative risks correcting preoperative general conditions may improve the survival rate.

Key words
colorectal cancer, geriatric, clinicopathological analysis, operative risks, preoperative assessment

Reprint requests
Yuichi Machiki First Department of Surgery, Nagoya University of Medicine
65 Tsurumai, shouwa-ku, Nagoya, 466 JAPAN

Accepted
September 12, 1990

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