학술논문

Outcomes following major resection for colorectal cancer in patients aged 65+ years: a population-based study in Queensland, Australia.
Document Type
Academic Journal
Author
Youl PH; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.; Theile DE; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.; Translational Research Institute, University of Queensland, Brisbane, Australia.; Moore J; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.; Harrington J; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.; Philpot S; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Source
Publisher: Wiley-Blackwell Publishing Asia Country of Publication: Australia NLM ID: 101086634 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1445-2197 (Electronic) Linking ISSN: 14451433 NLM ISO Abbreviation: ANZ J Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The risk of developing colorectal cancer (CRC) increases with increasing age. As surgery is the primary treatment for CRC, our aim was to examine outcomes following major resection for CRC in a cohort of individuals aged ≥65 years.
Methods: This population-based retrospective study included 18 339 patients aged ≥65 years diagnosed with CRC from 2007 to 2016. Multivariate logistic regression was used to examine factors associated with the likelihood of having major resection, 30-day mortality and laparoscopic surgical procedure. Cox proportional hazards was used to examine factors associated with risk of death at 2 years post-surgery.
Results: Overall, 77.8% (n = 14 274) of patients had a major resection. Males and patients ≥75 years were significantly less likely to have a major resection (P < 0.001 and P < 0.001, respectively). Thirty-day mortality was 3.1% and 2-year overall survival was 78.7%. After adjustment, factors such as increasing age (≥75 years), ≥2 comorbidities, emergency admission, open surgical procedure and treatment in a public hospital were all independently and significantly associated with poorer outcomes. The likelihood a patient had a laparoscopic procedure was significantly lower for those from a disadvantaged area (P < 0.001), emergency admission (P < 0.001) as well as for those treated in a public versus private hospital (P < 0.001).
Conclusions: Post-operative mortality increased, and 2-year survival decreased after age 75 years. The finding of significantly lower rates of laparoscopic surgery for patients from disadvantaged areas and those treated in a public hospital requires further investigation.
(© 2021 Royal Australasian College of Surgeons.)