Outcomes in elderly patients following surgery for colorectal cancer in the veterans affairs health care system

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Abstract
Aim : To compare 30‐day and 5‐year mortality in elderly vs. younger patients following surgical resection for colorectal cancer. Methods : A cohort study of patients admitted to VA hospitals with a new diagnosis of colorectal cancer who underwent surgical resection between October 1990 and September 2000. Cumulative survival rates (30‐day and 5‐year) were calculated from Kaplan–Meier estimates and adjusted risks of death were estimated using Cox proportional hazards models. Results : We identified 34 888 individuals with a new diagnosis of colorectal cancer between October 1990 and September 2000, of whom 22 633 (65%) underwent surgical resection. The 30‐day mortality following resection for rectal and colon cancer, respectively, for patients <65 years was 2.1 and 2.8% compared with 4.9 and 5.6% for those ≥65 years. The 5‐year cumulative survival for rectal and colon cancer for patients <65 years was 54.0 and 57.6% compared with 44.5 and 46.6% for those ≥65 years. In patients ≥65 years with rectal or colon cancer, after adjustment, 30‐day mortality was 2 times greater and 5‐year mortality was 1 times greater than in younger patients. Conclusions : Older age is an independent predictor of increased short‐term and long‐term mortality following surgery in patients with rectal and colon cancer.