The Significance of Lymph-node Dissection and Combined Excision of Other Organs in Colorectal Cancer Patients Aged 80 Years or More

Hideyuki Ishida*, Takeo Iwama, Yoshio Mishima

*Second Department of Surgery, Saitama Medical Center, Saitama Medical School
Second Department of Surgery, Tokyo Medical and Dental University

The outcomes of surgery in 61 patients with colorectal cancer aged 80 years or more (elderly group) operated on from 1984 to 1994 were compared with those of 160 patients aged 70-79 (control group), to clarify the significance of lymph-node dissection and combined excision of other organs in elderly patients with colorectal cancer. In patients with resectable disease, D2- or D3-resection was performed it 6l% of the elderly group and 72% of the control group (NS). The occurrence of postoperative major complications as well as declined quality of life had no correlation with the types of lymph-node dissection performed in the 2 groups. In patients undergoing combined excision of other organs, one of 6 patients in the elderly group exclusively died within 30 days of operation. The mean survivals according to the types of lymph-node dissection (D₃·D₂ vs. D₁·D₀) in patients with curative resection (Cur A or Cur B) were as follows: aged≫85; 3.1 years vs. 3.1 years (NS),aged 80-84; 0.8 vs. 2.9 (NS), aged 70-79; 5.4 vs. 7.1 (p<0.05). In conclusion, colorectal cancer patients aged 80 years or more should be carefully indicated for combined excision of other organs, and lymph-node dissection of D₂- or D₃-level is safe and feasible in those patients although the lymph-node dissection may give no impact on the prolongation of survival in the extremely aged patients aged 85 years or more with a limited life expectancy of 5-6 years.

Key words
colorectal cancer in the elderly, lymph-node dissection, combined excision of other organs

Reprint requests
Hideyuki Ishida Second Department of Surgery, Saitama Medical Center, Saitama Medical School
1981 Kamoda Tsujido-cho, Kawagoe City, 350 JAPAN

Accepted
June 12, 1996

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