Abstract
OBJECTIVE:Colorectal cancer is one of the most frequent types of malignant neoplasms. Age is a risk factor for this disease, with 75% of cases diagnosed in patients older than 65 years. Complications such as obstruction, hemorrhage, and perforation are present in more than one-third of cases and require emergency treatment. We aim to analyze the profile of elderly patients undergoing surgery for complicated colorectal cancer, and to evaluate factors related to worse short-term prognosis.METHODS:A retrospective analysis of patients who underwent emergency surgical treatment for complicated colorectal cancer was performed. Demographics, clinical, radiological and histological data were collected.RESULTS:Sixty-seven patients were analyzed. The median age was 72 years, and almost half (46%) of the patients were female. Obstruction was the most prevalent complication at initial presentation (72%). The most common sites of neoplasia were the left and sigmoid colon in 22 patients (32.8%), and the right colon in 17 patients (25.4%). Resection was performed in 88% of cases, followed by primary anastomosis in almost half. The most frequent clinical stages were II (48%) and III (22%). Forty-three patients (65.7%) had some form of postoperative complication. Clavien-Dindo grades 1, 2, and 4, were the most frequent. Complete oncologic resection was observed in 80% of the cases. The thirty-day mortality rate was 10.4%. Advanced age was associated with worse morbidity and mortality.CONCLUSION:Elderly patients with complicated colorectal cancer undergoing emergency surgery have high morbidity and mortality rates. Advanced age is significantly associated with worse outcomes.
Highlights
Colorectal cancer is the third most common malignancy in men, the second most common malignancy in women, and the fourth most significant cause of death from malignant neoplasms in the world [1]
The American Joint Committee on Cancer (AJCC) classification was used for clinical staging based on perioperative data [17]
Sixty-seven elderly patients were included in this study during a period of four years
Summary
Colorectal cancer is the third most common malignancy in men, the second most common malignancy in women, and the fourth most significant cause of death from malignant neoplasms in the world [1]. In 2012, there were an estimated 1.4 million cases and more than 690.000 deaths. Worldwide mortality trends vary and are increasing in less developed countries with limited resources such as Brazil [2]. According to the Brazilian National Institute of Cancer (INCA), in 2016, there were 16.660 and 17.620 estimated new cases in men and women, respectively [3].
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