A Clinicopathological Study on Advanced Colorectal Cancer in the Patients Older than 90 Years of Age Who Underwent Operation

Yasunori Hino, Hajime Hashimoto, Koujirou Kuroiwa, Tadao Takahashi

Department of Surgery, Tokyo Metropolitan Geriatric Hospital

The characteristics of clinicopathological findings of patients more than 90 years old presenting with colorectal cancer were investigated. The subjects were 20 patients (21 operations) who had undergone surgery during 1987-1997. These were compared with 103 controls aged 75-79, and also with 17 patients more than 90 years old in early period (1974-1986). In the subject group, the most common preoperative symptom was a sign of intestinal obstruction (38%), which occurred significantly more frequently than in the control group (p<0.05). The incidence of emergency surgery in patients 90 years and older was declined from 47% (in early period) to 33% (in late period), but was still in higher level than that of control group (p<0.05). The overall operative mortality rate in the subject group was 4.8%, which had been improved more than in early period, and was comparable to that of the control group (3.9%). During elective surgery, no patients in the subject group was lost perioperatively throughout both periods. The resection rate and the curative resection rate (95%, 90%) were similar to those of the control group (95%, 83.6%). There was no significant difference between the two groups with regard to preoperative coexisting disorders. Pathological findings demonstrated that Dukes B group was predominant in the subject group (p<0.05). It was concluded that surgery for patients over 90 years of age with colorectal cancer is warranted and diagnostic efforts should be made to avoid emergency surgery.

Key words
colorectal cancer in patients aged 90 and over, colorectal surgery in their nineties

Reprint requests
Yasunori Hino Department of Surgery, Tokyo Metropolitan Geriatric Hospital
35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015 JAPAN

Accepted
February 12, 1998

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