Defining Colon Cancer in the Elderly Based on the Perspective of Survival

Keiichiro Ishibashi, Shunsuke Haga, Shungo Endo, Hiroyuki Koto, Naoki Takahashi, Kazuhiko Yoshimatsu, Masahiko Hashimoto, Tetsuro Kajiwara

Department of Surgery, Tokyo Women's Medical College Daini Hospital

Elderly patients were defined from their survival rate, and elderly and non-elderly subjects were investigated. Overall, 377 patients with excised colon cancer were studied. Subjects were divided into two groups based on age. Elderly patients were divided from the non-elderly by the lowest age at which there was a significant difference in the cumulative 5-year survival rate. There was a significant difference in the survival rate of subjects over 77 years as compared to those below 77 years. Therefore, subjects over 77 years were defined as the elderly group. There were no differences in clinicopathological factors, incidence of complications or frequency of surgical death. Many subjects died of causes other than original cancer in the elderly group. There was no difference in the cumulative 5-year survival rate between the elderly and non-elderly groups, when subjects who died from other diseases or cancers of other organs were excluded from the analysis. The influence of colon cancer itself on survival of the elderly seemed to be similar to that in the non-elderly group. The ratio of the cumulative survival rate determined in subjects excluding those who had a recurrence, or who died from the original cancer or a recurrence, to the cumulative surivival probability calculated from a life table was 0.857 in the elderly group and 0.921 in the non-elderly group, suggesting that the influence of surgery for colon cancer on patient survival is appreciable in the elderly. These results suggest that surgical procedures should be selected for elderly patients which maintain radicality, while general conditions including potential complications taking into consideration.

Key words
colon cancer, survival rate, elderly people

Reprint requests
Keiichiro Ishibashi Department of Surgery, Tokyo Women's Medical College Daini Hospital
2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116 JAPAN

Accepted
June 12, 1996

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