2005 Abstracts: Outcome of Surgery for Rectal Cancer in Octogenarians
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Outcome of Surgery for Rectal Cancer in Octogenarians
Elizabeth Andereggen, Pascal Gervaz, Philippe Morel, University Hospital Geneva, Geneva, AE, Switzerland
Introduction: Life expectancy of the elderly population is increasing. Therefore, curative treatment of cancer in elderly patients represents an important challenge. The aim of this study was to assess the outcome of surgery for rectal cancer in patients 80 years or more of age.
Methods: A retrospective study of 29 patients older than 80 years who presented with the diagnosis of rectal adenocarcinoma in our institution between 1997 and 2001 was undertaken. Results: 24 out of 29 patients (83%) underwent surgery, 23 being operated electively. Twenty out of 24 patients (83%) underwent resection with a curative intent (abdominoperineal resection N=7, low anterior resection N=7, Hartmann's procedure N=2, transanal resection N=4). Four patients (17%) had a palliative procedure. Eight out of 20 patients (33%) operated with curative intent underwent preoperative radiotherapy. Median hospital stay was 13 (range 10-35) days. Postoperative complications occurred in 11 patients (46%). Overall operative mortality was 12.5% (3/24 patients). When considering only elective procedure with curative intent, operative mortality was 5% (1/20 patients) and 2-year overall survival was 80%. At the time of last follow-up, 13 patients were alive, five of them with no evidence of recurrent disease at 5 years, for an overall 5-year survival rate of 58%. Four out of the 7 deaths which occurred 8 months to 5 years after surgery were due to medical causes unrelated to cancer. Conclusion : In our experience, two thirds of patients older than 80 years who presented with rectal cancer underwent surgery with curative intent. In this population, good results in terms of short-term survival can be achieved, at the price of a relatively elevated postoperative mortality and morbidity.
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