Colorectal cancer in the elderly and the influence of lead time bias: better survival does not equate with improved life expectancy

Autor: Raymond Oliphant, Praveen Sharma, Katrina Knight, Claire McKenzie, Raymond Hammill, Maria McCann, Angus Macdonald, Fraser Maxwell
Rok vydání: 2016
Předmět:
Zdroj: International Journal of Colorectal Disease. 31:553-559
ISSN: 1432-1262
0179-1958
DOI: 10.1007/s00384-015-2496-z
Popis: Poorer outcomes in those aged ≥80 years who undergo colorectal cancer surgery have been previously reported. Little is known about the natural history of those managed non-operatively. We explored outcomes in all patients with colorectal cancer aged ≥80 years at time of diagnosis based on treatment received. Patients ≥80 years diagnosed with colorectal cancer in one hospital trust between 1998 and 2011 were identified from a prospectively maintained database. Primary endpoints were age at diagnosis, age at death/censor and mortality at 30, 90 and 365 days. Six hundred sixty-eight patients were identified. Four hundred twelve (61.7 %) underwent surgery, 44 (6.6 %) received endoscopic therapy and 212 (31.7 %) had no active treatment. Of those who underwent surgery, 359 (87.1 %) had resectional surgery, 34 (8.3 %) defunctioning only, 13 (3.2 %) received bypass surgery and 6 (1.5 %) had an open and close laparotomy. The mean age at diagnosis was younger in those who underwent surgical resection (83.7 years) compared to those having defunctioning surgery (84.9 years, P = 0.043), endoscopic therapy (85.1 years, P = 0.008) or no surgical intervention (85.6 years, P
Databáze: OpenAIRE
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