WHICH KIND OF SURGERY IN ELDERLY PEOPLE FOR COLORECTAL-CANCER

Cole-rectal cancers are of high incidence in elderly patients. Differe nt clinical features and the peculiar behavior of the tumor may influe nce surgical results and should be considered in the decision making, when the surgeon has to decide whether to perform radical gut resectio n or less straining palliative procedures. In a retrospective study, 1 02 large bowel cancer patients are analyzed submitted to surgery in th e period 1989-1994. Patients were divided in two age classes: Group A: above 70 years of age, 45 cases (44.2 %); Group B: under 70 years of age, 57 cases (55.8 %). Emergency surgery procedures were necessary in 35 patients (34.4 %), 20 cases (57 %) in Group A and 15 cases (43 %) in Group B. Radical resections could be performed in 25 (37 %) old pat ients, 67 % of the cases underwent a curative resection. Perioperative mortality and surgical complication rates were significantly higher i n Group A than in Group B. The technical and biological difficulties i n performing radical curative resections, the high complication rates and the occurrence of negative results of treatments provide a reason for careful evaluation of the risk/benefit ratio in older patients, wh ere less straining palliative therapies may sometimes offer similar re sults.