P-249 Short-term results of surgery in elderly (>65 years) versus younger patients with Stage I-II colonic adenocarcinoma: a case-control study

Abstract

Introduction: Colorectal cancer is a common malignancy especially in elderly patients, who usually have several comorbidities (e.g., cardiovascular diseases requiring anticoagulation therapy) potentially leading to increased short- and long-term operative risks. Unfortunately, colorectal cancer rarely affects young people and the most part of patients are usually scheduled as ASA (American Society of Anesthesiologists) II-III and thus considered generally at risk. The aim of this study was to compare the short-term results of curative surgery in elderly (>65 years) versus younger patients with colonic adenocarcinoma. Methods:We retrospectively reviewed our medical record database of a group of 97 patients (67 men, 69.1%; 30 women, 30.9%) who underwent surgical resection for left (N = 36, 37.1%) or right (N = 61, 62.9%) Stage I-II (Dukes A-B) colonic adenocarcinoma. The population was divided into two Groups of sex-matched patients: (i) younger (≤65 years; N = 31, 32%) and (ii) older (>65 years; N = 66, 68%). The following parameters were considered: comorbidities (diabetes mellitus, cardiovascular diseases and anticoagulation therapy, chronic pulmonary diseases), operative time and intraoperative bleeding, postoperative complications, including serious anastomotic leak, pneumonia and urinary infections, and postoperative hospital stay. Student's t-test, chi-squared (X2) and Fisher exact probability test were used for comparing parameters between Groups. Results: The results are reported in the Table. The two Groups were homogeneous with regard to all considered comorbidities. Operative time (149 ± 32 vs. 162 ± 36 min, p = 0.089) and postoperative hospital stay (7.2 ± 1.7 vs. 8.0 ± 2.1, p = 0.067) were shorter in younger patients, but the difference was not significant (p = NS). Similarly, both intraoperative bleeding (78 ± 26 vs. 90 ± 34 mL, p = 0.085) and postoperative complications were reduced, in lack of statistical significance. Conclusion:We conclude that elderly patients with colonic cancer should not be considered overall at increased risk with respect to younger, when a surgical resection is necessary. However, older (>65) patients require a careful individual preoperative evaluation in the presence of more than one comorbidity, because they are usually multiple drug users.