Comparison of Survival Analysis After Surgery for Colorectal Cancer in Above 80 Years (Oldest-Old) and Below 80 Years Old Patients

There are several predictor scales to assess the patients pre-operatively and thus inferring outcomes after surgery; for example, ASA (American Society of Anesthesiologists) scoring, SORT (Surgical Outcome Risk Tool), and APACHE II (Acute Physiology and Chronic Health Disease Classification System II). However, most surgeons would see advancing age as an important predictor of surgical outcome especially after a major surgery. Chronological age may not be the only determinant outcome after surgery. In a group of colonic cancer patients, we compared standard pre-defined outcomes in subjects above 80 years to below 80 years. Specifically we compared Clinical, surgical, pathological, and survival data of 71 oldest old patients (≥80 years) and 67 younger (<80 years) patients treated by surgery between January 2018 and January 2020. No differences in terms of intra- and peri-operatory mortality, post-operative complications, length of hospital stay, and needing of Intensive Care Unit were found between the two groups. Univariate and multivariate analyses identified, above all, laparotomy, anastomotic leak, lymph node, and hematogenous metastasis as independent prognostic factors for a worse outcome. The Kaplan-Meier curves demonstrated that both the 180-day survival and the overall survival overlapped. The results of our study highlight how chronological age should not to be considered a barrier for a proper treatment, pointing at surgery as a feasible approach also in elderly patients. Our findings may open the way for planning “ad hoc” screening protocols in this subset of patient.