Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

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.

Expression of long non coding RNA H19& miR-675 in colorectal cancer and ulcerative colitis patients

“…In our study, demographic data which comprises age and gender showed a signi cant difference regarding age where CRC group showed a higher mean of age with statistical signi cance when compared to both control and UC groups who showed a lower mean in their ages, this comes in accordance with other studies [3,23,24] which stated that colorectal cancer is mainly a disease of the elderly [23]or above the age of 55 [24,10]. These results were previously challenged in an Egyptian study [25] that recognized a relatively high percentage of patients diagnosed with CRC at a younger age group (between 20-40 years).…”

Disproportionately high failure to rescue rates after resection for colorectal cancer in the geriatric patient population – A nationwide study

“…For example, a meta‐analysis of 16 RCT has shown that while the occurrence of surgical complications did not change the relative risk for non‐surgical complication drops to 0.4 15 . In the same line‐specific geriatric assessment improves perioperative outcome and outcome during chemotherapy 16,17 . Considering these, especially older patients would benefit from reduced perioperative complication rate.…”

“… 15 In the same line‐specific geriatric assessment improves perioperative outcome and outcome during chemotherapy. 16 , 17 Considering these, especially older patients would benefit from reduced perioperative complication rate. In the light of these data, it seems striking that patients above 80 years were more likely to be treated in lower volume centers than younger patients.…”

Using machine learning algorithms to predict 28-day mortality in critically ill elderly patients with colorectal cancer

“…Aging patients with CRC possess a higher risk for treatment-associated morbidity and mortality than younger patients. 25 For example, a study conducted in Japan showed that elderly patients with CRC and Glasgow Prognostic Score (GPS) ≥2 exhibited a significantly lower 5-year survival rate than those with GPS 0 or 1. 26 However, there is a paucity of data regarding critically ill, elderly patients with CRC who are admitted to ICU.…”