How should patients 80 years of age or older with colorectal carcinoma be treated? - Long-term and short-term outcome and postoperative cytokine levels

PURPOSE: The aim of this study was to determine how extensive resection aff ects operative morbidity, mortality, and long-term survival in elderly pati ents with colorectal cancer. METHODS: A total of 119 patients 80 years of a ge or older were given a diagnosis of colorectal carcinoma at our hospital between 1985 and 1997. Eleven patients who did not undergo surgery were exc luded. The remaining 108 patients underwent laparotomy and were reviewed. S erum levels of interleukin-G were measured perioperatively in 22 patients t o assess the degree of operative stress. RESULTS: Potentially curative rese ction was performed in 64 (88.9 percent) of the 72 patients in the active p erformance status group and 13 (36.1 percent) of the 36 patients in the sed entary performance status group (P < 0.001). The in-hospital mortality rate was 8.3 percent in group the active performance status group and 38 percen t in the sedentary performance status group (P = 0.007). Patients in the se dentary performance status group and those who underwent emergency operatio ns had higher levels of IL-G than patients in the active performance status group or those who underwent elective operations. CONCLUSIONS: Preoperativ e performance status, operative curability, and tumor stage have a signific ant impact on outcome in patients with colorectal cancer who are 80 years o f age or older. Knowledge of early postoperative response of IL-6 is useful in predicting postoperative mortality and morbidity in this subgroup of pa tients.