Colorectal Cancer in Octogenarians: Results of Treatment, a Descriptive Clinical Study

Colorectal cancers (CRCs) often occur in octogenarians. However, data on treatment and survival are sparse. Octogenarians were studied in order to gain data on treatment, outcomes, and survival related to CRC. All consecutive octogenarians with CRC in the period of 2002 - 2008 were included. An extensive review of hospital records was carried out. Patients were divided into two groups, as follows: group 1 included patients who were alive after five years of follow-up, while group 2 comprised patients who died within 5 years of their diagnosis. Cause of death was determined and classified as related to cancer, non-related, or because of treatment. One hundred and eleven octogenarians were diagnosed with CRC (82 colon cancers and 29 rectal cancers). Patients in group 2 had a significantly higher disease stage compared with group 1 (P < 0.001). Patients in group 1 more often underwent surgery with curative intent (P < 0.0001). There was no difference in clinical presentation or localization of the malignancy. In group 1, 14 patients died more than 5 years after surgery. The cause of death was not related to cancer in 100% of cases. In group 2, 29 (46.0%) died as a direct consequence of CRC, 14 (22.2%) due to the treatment, and 20 (31.7%) died due to non-cancer-related causes. The overall 5-year survival rate was 40% in colon cancer patients and 51.7% in rectal cancer patients. The Charlson age co-morbidity scores were significantly lower in colon cancer patients in group 1 (P = 0.005). This was not the case in patients with rectal cancer. The co-morbidity score is important in survival after surgery. Forty-four percent of octogenarians with CRC died because of non-tumor-related disease or illness. Fit elderly people can benefit from standard therapy for CRC.