Purpose: The purpose of this study was to investigate the short-term outcomes and prognosis of elderly and very elderly colorectal cancer (CRC) patients after primary CRC surgery using propensity score matching (PSM).
Methods: This study retrospectively collected the medical records of CRC patients ≥ 65 years old undergoing primary CRC surgery from Jan 2011 to Jan 2020. Short-term outcomes, overall survival (OS) and disease-free survival (DFS) were compared between very elderly CRC patients (≥ 80 years old) and elderly CRC patients (65-79 years old).
Results: A total of 2084 patients were enrolled for analysis. After PSM, 331 very elderly patients were matched to 331 elderly patients. In terms of short-term outcomes, the very elderly patients had longer postoperative hospital stays (p = 0.007) after PSM. In terms of OS, it was found that age (p < 0.01, HR = 1.878, 95% CI 1.488-2.371), tumor stage (p < 0.01, HR = 1.865, 95% CI 1.603-2.170), overall complications (p < 0.01, HR = 1.514, 95% CI 1.224-1.872) and major complications (p = 0.001, HR = 2.012, 95% CI 1.319-3.069) were independent prognostic factors. For DFS, age (p < 0.01, HR = 1.816, 95% CI 1.579-2.088), tumor stage (p < 0.01, HR = 1.816, 95% CI 1.579-2.088), overall complications (p = 0.002, HR = 1.379, 95% CI 1.128-1.685) and major complications (p = 0.002, HR = 1.902, 95% CI 1.259-2.874) were found to be independent prognostic factors. Moreover, elderly patients had a better OS and DFS than very elderly patients.
Conclusion: Very elderly patients had a poorer prognosis than elderly patients after primary CRC surgery. Surgeons should be cautious when treating very elderly CRC patients.
Keywords: Colorectal cancer; Disease-free survival; Elderly; Overall survival; Propensity score matching.
© 2022. The Author(s).