Abstract
Six out of every 10 new colorectal cancer (CRC) diagnoses are in people over 65 years of age. Current standardized surgical approaches have proved to be tolerable on the elderly population, although post-operative complications are more frequent than in the younger CRC population. Frailty is common in elderly CRC patients with surgical indication, and it appears to be also associated with an increase of post-operative complications. Fast-track pathways have been developed to assure and adequate post-operative recovery, but comprehensive geriatric assessments (CGA) are still rare among the preoperative evaluation of elderly CRC patients. This review provides a thorough study of the effects that a CGA assessment and a geriatric intervention have in the prognosis of CRC elderly patients with surgical indication.
Highlights
Colorectal cancer (CRC) is the third most common cancer in the world
In a single-center retrospective cohort study that included 310 patients aged 70 years or older who were admitted for elective CRC surgery in a tertiary level hospital, it was found how a daily comprehensive geriatric assessments (CGA)-based hospital assistance was associated with a lower incidence of delirium and other geriatric syndromes, as well as fewer blood transfusions
We found eleven randomized clinical trials (RCTs) assessing the effect of physical exercise in surgical CRC patients over the age of 60 years, with sample sizes from 42 to 185 patients (Table 3)
Summary
Colorectal cancer (CRC) is the third most common cancer in the world. In 2019, the worldwide number of new CRC cases was 1,931,590, which accounts for 10% of new cancer diagnosis. The median age of CRC diagnosis is 67 years, with 56% of the cases newly diagnosed corresponding to patients ≥65 years, and 31% to patients ≥75 years [1]. Res. Public Health 2021, 18, 6072 median age at death is 72 years, and 45% of the deaths occur in patients ≥75 years old, with. 21% of them in the oldest (≥85 years) [1]. More than 90% of colorectal carcinomas are adenocarcinomas, other rare types include neuroendocrine, squamous cell, adenosquamous, spindle cell and undifferentiated carcinomas [6]
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