Risk Factors of Postoperative Complication and Prognostic Factors in Aged Patients with Resectable Colorectal Carcinomas by using Multivariate Analysis

Mariko Man-I¹⁾²⁾, Isamu Nishisho¹⁾, Hideyuki Mishima¹⁾ , Toshio Yagyu¹⁾²⁾, Nobuteru Kikkawa¹⁾³⁾ and Toshimasa Tsujinaka¹⁾

¹⁾Department of Surgery, Osaka National Hospital
²⁾Department of Surgery, Kaizuka Municipal Hospital
³⁾Department of Surgery, Minoh City Hospital

Background and Methods: We compared clinicopathological features in 284 colorectal carcinoma patients 75 years and older undergoing colorectal carcinoma resection in the last 33 years to those 2591 patients less than 75 years old, using multivariate analysis to identify risk factors in postoperative complications and prognostic factors in those 75 years and older. Results: The incidence of preoperative complications in older patients was 88.3% and that of postoperative complications 38.3%. Preoperative complications in such patients most commonly involved impaired pulmonary and circulatory function, low proteinemia, and anemia, while postoperative complications involved wound infection, ileus, derilium, respiratory complications, and anastomosis leakage. Operation time (X) was identified as a significant risk factor in postoperative complications by logistic regression analysis. The discriminant function was Z=-0.00828X+1.34141, indicating that postoperative complications can be minimized by minimizing operation time. Cumultaive survival was lower in older patients and curability the most important prognostic factor based on Cox's proportional hazard model. Conslusion: These results suggest that curative resection is indicated with D2 lymph node dissection in older colorectal carcinoma patients in good preoperative general conditions so long as operation time is minimized to prevent postoperative complications.

Key words
colorectal carcinomas in older patients, preoperative complications, postoperative complications, prognostic factors

Reprint requests
Mariko Man-I Department of Surgery, Osaka National Hospital
2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006 JAPAN

Accepted
March 27, 2002

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