TY - JOUR
T1 - The gap in postoperative outcome between older and younger patients with stage I-III colorectal cancer has been bridged; results from the Netherlands cancer registry
AU - Brouwer, Nelleke P. M.
AU - Heil, Thea C.
AU - Rikkert, Marcel G. M. Olde
AU - Lemmens, Valery E. P. P.
AU - Rutten, Harm J. T.
AU - de Wilt, Johannes H. W.
AU - van Erning, Felice N.
N1 - Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/7
Y1 - 2019/7
N2 - Aim of the study: Previous studies have shown that older patients benefited less than younger patients from surgical treatment for colorectal cancer (CRC). However, CRC care has advanced over time, and it is time to assess whether the difference in postoperative mortality between older and younger CRC patients is still present.Methods: Patients with primary stage I-III CRC diagnosed between 2005 and 2016 were selected from the Netherlands Cancer Registry (N = 111,778). Trends in postoperative mortality and 1-year postoperative relative survival (RS) were analysed, stratified according to age (= 75 years) and tumour location (colon versus rectum). One-year postoperative RS was analysed to correct for background mortality in the older population.Results: Between 2005 and 2016, 30-day postoperative mortality showed a stronger decrease for older patients (from 10.0% to 4.0% for colon cancer [p <0.001] and from 8.3% to 2.7% for rectal cancer [p <0.001]) compared with younger patients (from 2.0% to 0.9% for colon cancer [p <0.001] and from 1.4% to 0.7% for rectal cancer [p = 0.01]). Between 2005 and 2016, also 1-year RS increased more for older patients (from 84.8% to 94.6% for colon cancer and from 86.1% to 97.2% for rectal cancer) compared with younger patients (from 94.0% to 97.8% for colon cancer and from 96.3% to 98.8% for rectal cancer).Conclusion: Between 2005 and 2016, differences in postoperative mortality between older and younger CRC patients decreased. One-year postoperative RS was almost equal for older and younger patients in 2015-2016. This information is crucial for shared decision-making on surgical treatment. (C) 2019 Elsevier Ltd. All rights reserved.
AB - Aim of the study: Previous studies have shown that older patients benefited less than younger patients from surgical treatment for colorectal cancer (CRC). However, CRC care has advanced over time, and it is time to assess whether the difference in postoperative mortality between older and younger CRC patients is still present.Methods: Patients with primary stage I-III CRC diagnosed between 2005 and 2016 were selected from the Netherlands Cancer Registry (N = 111,778). Trends in postoperative mortality and 1-year postoperative relative survival (RS) were analysed, stratified according to age (= 75 years) and tumour location (colon versus rectum). One-year postoperative RS was analysed to correct for background mortality in the older population.Results: Between 2005 and 2016, 30-day postoperative mortality showed a stronger decrease for older patients (from 10.0% to 4.0% for colon cancer [p <0.001] and from 8.3% to 2.7% for rectal cancer [p <0.001]) compared with younger patients (from 2.0% to 0.9% for colon cancer [p <0.001] and from 1.4% to 0.7% for rectal cancer [p = 0.01]). Between 2005 and 2016, also 1-year RS increased more for older patients (from 84.8% to 94.6% for colon cancer and from 86.1% to 97.2% for rectal cancer) compared with younger patients (from 94.0% to 97.8% for colon cancer and from 96.3% to 98.8% for rectal cancer).Conclusion: Between 2005 and 2016, differences in postoperative mortality between older and younger CRC patients decreased. One-year postoperative RS was almost equal for older and younger patients in 2015-2016. This information is crucial for shared decision-making on surgical treatment. (C) 2019 Elsevier Ltd. All rights reserved.
KW - Aged
KW - Netherlands/epidemiology
KW - Rectal neoplasms/mortality
KW - Rectal neoplasms/surgery
KW - Colonic neoplasms/mortality
KW - Colonic neoplasms/surgery
KW - Colorectal neoplasms
KW - Postoperative mortality
KW - COLON-CANCER
KW - HEALTH-CARE
KW - SURGERY
KW - MANAGEMENT
KW - PREHABILITATION
KW - MULTIMORBIDITY
U2 - 10.1016/j.ejca.2019.04.036
DO - 10.1016/j.ejca.2019.04.036
M3 - Article
C2 - 31163335
SN - 0959-8049
VL - 116
SP - 1
EP - 9
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -