2019 ACS Clinical Congress: Short-Term Survival in Elderly Patients Undergoing Surgery for Colon Cancer
Posted: Friday, November 22, 2019
According to research presented at the 2019 American College of Surgeons (ACS) Clinical Congress in San Francisco, elderly patients with advanced-stage colon cancer fared well overall in terms of short-term survival after segmental colectomy.
“We were interested in this topic because we know from [the] Centers for Disease Control and Prevention data that patients 85 and older have the highest incidence rate of colon cancer,” noted Roma Kaur, MD, of the University of Rochester Medical Center, in an ACS press release. “According to the U.S. Census Bureau, this is the fastest-growing segment of the geriatric population. Given the burden of colon cancer in this cohort, we were hoping to identify and better understand factors that were associated with survival in these patients.”
Using the New York State Cancer Registry and Statewide Planning Research & Cooperative System, the retrospective study identified 3,779 patients aged 85 and older with stage II or III colon cancer who underwent segmental colectomy between 2004 and 2014. A total of 27.4% of participants had experienced a major complication related to surgery, and for 48.4%, the colectomy was not elective. However, at 30 days after surgery, 89.4% of patients were alive, with 83.2% still alive at 90 days after surgery.
The study identified factors that showed an association with worse survival outcomes—including emergency surgery, invasive surgical methods, and preoperative complications—as well as with improved outcomes. When patients were discharged directly to another health-care facility (about 42% of study participants), they experienced a reduction in the odds of mortality by 89% at 30 days and by 58% at 90 days. In addition, patients whose surgeons more frequently performed this type of surgery tended to fare better, with an approximately 59% short-term reduction in the odds of mortality.
Disclosure: For full disclosures of the study authors, visit facs.org/clincon2019.