Clinicopathological Characteristics and Prognosis of Elderly Cases of Perforated Colon Cancer

The clinicopathological characteristics of perforated colon cancer in elderly patients over 75 were investigated in comparison with those in patients under 75. The rate of perforations among the total operations was 3.0 % for patients under 75 but 19.4 % for those over 75. The frequency o free perforations on the oral side was one out of four cases (25.0 %) in those under 75 and three out of six (50.0 %) in those over 75. The site of the perforated carcinoma was centered in the lower part of the large bowel in patients under 75, but was distributed throughout the large bowel in the elderly patients. The macroscopic type of the cancer was type 2 in more than 75 % of the cases both under and over 75, and the depth of wall penetration tended to be less in elderly patients. Shock symptom were seen in 50.0 % of patients under 75 and in 33.3 % of those over 75. The three cases of direct deaths all had symptoms of shock. Cases with a period of at least 24 hours from onset until surgery accounted for 66.6 % of elderly patients, but there was no relation between this period and the mortality rate. Elderly patients showed high rates of pre and postoperative complications and such patients showed a high mortality rate.