COLORECTAL-CARCINOMA IN PATIENTS AGED 75-YEARS AND MORE - FACTORS INFLUENCING SHORT AND LONG-TERM OPERATIVE MORTALITY

A review of 238 patients aged over 75 years and operated on for colore ctal cancer was undertaken to analyse factors influencing short and lo ng-term operative mortality. Operative mortality in the first postoper ative month was 13% (n = 31) and 17% (n = 35) in the first year. Four factors influenced significantly postoperative mortality in the first month: postoperative complications (p = 0.0001) related to medical com plications (p = 0.0001), emergency surgery (p = 0.007), type of anesth esia (p = 0.01). Mortality during the first year (excluding patients w ho died in the first month) was higher in females (p = 0.05), in patie nts subjected lo emergency operation (p = 0.004), in patients with pre existing, cerebrovascular accident (p = 0.04) and in patients with Duk es C staging (p = 0.0001). A multivariate analysis with Cox's model re vealed 3 prognostic factors: Dukes staging (p = 0.0001), medical compl ications in the postoperative period (p = 0.0001) and type of anesthes ia (p = 0.0009). Age as an isolated factor is not a contraindication t o colorectal surgery in elderly patients presenting colonic or rectal carcinoma. Prognosis in elderly patients is first correlated to the co ntrol of postoperative mortality undergoing until the first year and t hen to the cancer itself.