Outcomes of elderly patients undergoing emergency surgery for complicated colorectal cancer: a retrospective cohort study
Clinics; 74 (), 2019
Publication year: 2019
OBJECTIVE:
Colorectal cancer is one of the most frequent types of malignant neoplasms. Age is a risk factor for this disease, with 75% of cases diagnosed in patients older than 65 years. Complications such as obstruction, hemorrhage, and perforation are present in more than one-third of cases and require emergency treatment. We aim to analyze the profile of elderly patients undergoing surgery for complicated colorectal cancer, and to evaluate factors related to worse short-term prognosis.METHODS:
A retrospective analysis of patients who underwent emergency surgical treatment for complicated colorectal cancer was performed. Demographics, clinical, radiological and histological data were collected.RESULTS:
Sixty-seven patients were analyzed. The median age was 72 years, and almost half (46%) of the patients were female. Obstruction was the most prevalent complication at initial presentation (72%). The most common sites of neoplasia were the left and sigmoid colon in 22 patients (32.8%), and the right colon in 17 patients (25.4%). Resection was performed in 88% of cases, followed by primary anastomosis in almost half. The most frequent clinical stages were II (48%) and III (22%). Forty-three patients (65.7%) had some form of postoperative complication. Clavien-Dindo grades 1, 2, and 4, were the most frequent. Complete oncologic resection was observed in 80% of the cases. The thirty-day mortality rate was 10.4%. Advanced age was associated with worse morbidity and mortality.CONCLUSION:
Elderly patients with complicated colorectal cancer undergoing emergency surgery have high morbidity and mortality rates. Advanced age is significantly associated with worse outcomes.
Factores de Edad, Brasil, Neoplasias Colorrectales/complicaciones, Neoplasias Colorrectales/mortalidad, Neoplasias Colorrectales/patología, Neoplasias Colorrectales/cirugía, Comorbilidad, Tratamiento de Urgencia/mortalidad, Unidades de Cuidados Intensivos/estadística & datos numéricos, Tiempo de Internación, Estadificación de Neoplasias, Complicaciones Posoperatorias/mortalidad, Pronóstico, Estudios Retrospectivos, Factores de Riesgo, Estadísticas no Paramétricas