The changing impact of age on colorectal cancer surgery. A trend analysis

Objective  The aim of the study was to evaluate the changing influence of age on the outcomes of colorectal cancer surgery in a retrospective trend analysis. Methods  Data on 985 patients undergoing colorectal cancer surgery were collected during 1975–1984 and 1995–2004. Variables and outcomes of pa...

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Veröffentlicht in:Colorectal disease 2009-01, Vol.11 (1), p.13-18
Hauptverfasser: Nascimbeni, R., Di Fabio, F., Di Betta, E., Salerni, B.
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container_title Colorectal disease
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creator Nascimbeni, R.
Di Fabio, F.
Di Betta, E.
Salerni, B.
description Objective  The aim of the study was to evaluate the changing influence of age on the outcomes of colorectal cancer surgery in a retrospective trend analysis. Methods  Data on 985 patients undergoing colorectal cancer surgery were collected during 1975–1984 and 1995–2004. Variables and outcomes of patients aged
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A trend analysis</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Nascimbeni, R. ; Di Fabio, F. ; Di Betta, E. ; Salerni, B.</creator><creatorcontrib>Nascimbeni, R. ; Di Fabio, F. ; Di Betta, E. ; Salerni, B.</creatorcontrib><description>Objective  The aim of the study was to evaluate the changing influence of age on the outcomes of colorectal cancer surgery in a retrospective trend analysis. Methods  Data on 985 patients undergoing colorectal cancer surgery were collected during 1975–1984 and 1995–2004. Variables and outcomes of patients aged &lt; 65, 65–74, 75–84 and 85+ years were compared with intra‐ and interdecade analyses. Endpoints of the study were postoperative mortality, 5‐year overall and cancer‐related survivals. Results  The rate of elderly patients undergoing colorectal cancer surgery increased significantly from 1975–1984 to 1995–2004. Distribution of American Society of Anesthesiology score and cancer stage remained unchanged over time. The rate of palliative procedures decreased over time, most significantly in the older age groups. In 1995–2004 the palliation rate was similar across all age groups. The rate of emergency surgery also decreased, but it remained higher in older age groups. Operative mortality rate decreased over time across all age groups, but age‐related differences were still observed in the 1995–2004 series. Cancer‐related survival after curative surgery increased from 58% in 1975–1984 to 64% in 1995–2004 in 75+ years patients, while it increased from 56% to 78% in patients aged 74 years or younger. Conclusions  Elderly patients with colorectal cancer benefited substantially from healthcare progress during the last 30 years. The reduction of palliative procedures and the decline in operative mortality document the efficacy of not restricting the access to radical surgery for these patients.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/j.1463-1318.2008.01491.x</identifier><identifier>PMID: 18294264</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Colectomy - mortality ; Colectomy - trends ; colorectal cancer ; Colorectal Neoplasms - surgery ; Elderly ; Female ; Hospitals, University - statistics &amp; numerical data ; Humans ; Italy - epidemiology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Palliative Care - trends ; Retrospective Studies ; temporal trends</subject><ispartof>Colorectal disease, 2009-01, Vol.11 (1), p.13-18</ispartof><rights>2008 The Association of Coloproctology of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4061-c133104c6b4482280c9bfa591e72320d32fcc90494ebba5dfd0de009aad60b573</citedby><cites>FETCH-LOGICAL-c4061-c133104c6b4482280c9bfa591e72320d32fcc90494ebba5dfd0de009aad60b573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1463-1318.2008.01491.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1463-1318.2008.01491.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18294264$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nascimbeni, R.</creatorcontrib><creatorcontrib>Di Fabio, F.</creatorcontrib><creatorcontrib>Di Betta, E.</creatorcontrib><creatorcontrib>Salerni, B.</creatorcontrib><title>The changing impact of age on colorectal cancer surgery. A trend analysis</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Objective  The aim of the study was to evaluate the changing influence of age on the outcomes of colorectal cancer surgery in a retrospective trend analysis. Methods  Data on 985 patients undergoing colorectal cancer surgery were collected during 1975–1984 and 1995–2004. Variables and outcomes of patients aged &lt; 65, 65–74, 75–84 and 85+ years were compared with intra‐ and interdecade analyses. Endpoints of the study were postoperative mortality, 5‐year overall and cancer‐related survivals. Results  The rate of elderly patients undergoing colorectal cancer surgery increased significantly from 1975–1984 to 1995–2004. Distribution of American Society of Anesthesiology score and cancer stage remained unchanged over time. The rate of palliative procedures decreased over time, most significantly in the older age groups. In 1995–2004 the palliation rate was similar across all age groups. The rate of emergency surgery also decreased, but it remained higher in older age groups. Operative mortality rate decreased over time across all age groups, but age‐related differences were still observed in the 1995–2004 series. Cancer‐related survival after curative surgery increased from 58% in 1975–1984 to 64% in 1995–2004 in 75+ years patients, while it increased from 56% to 78% in patients aged 74 years or younger. Conclusions  Elderly patients with colorectal cancer benefited substantially from healthcare progress during the last 30 years. The reduction of palliative procedures and the decline in operative mortality document the efficacy of not restricting the access to radical surgery for these patients.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colectomy - mortality</subject><subject>Colectomy - trends</subject><subject>colorectal cancer</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Elderly</subject><subject>Female</subject><subject>Hospitals, University - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Palliative Care - trends</subject><subject>Retrospective Studies</subject><subject>temporal trends</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMFu1DAQhi0EoqXwCsgnbgkztuPYF6RqgXalVXspQurFcpzJNks2Weys2H17ku6qXJnLjDT_fCN9jHGEHKf6vMlRaZmhRJMLAJMDKov54RW7fFm8fp5FZizCBXuX0gYAdYnmLbtAI6wSWl2y5cMT8fDk-3Xbr3m73fkw8qHhfk186HkYuiFSGH3Hg-8DRZ72cU3xmPNrPkbqa-573x1Tm96zN43vEn049yv24_u3h8Vttrq_WS6uV1lQoDELKCWCCrpSyghhINiq8YVFKoUUUEvRhGBBWUVV5Yu6qaEmAOt9raEqSnnFPp24uzj83lMa3bZNgbrO9zTsk9O6VFgoOwXNKRjikFKkxu1iu_Xx6BDcrNFt3GzLzbbcrNE9a3SH6fTj-ce-2lL97_DsbQp8OQX-tB0d_xvsFvdfl_M4AbIToE0jHV4APv5yupRl4X7e3bg7c_toV7hwj_IvFKiPTQ</recordid><startdate>200901</startdate><enddate>200901</enddate><creator>Nascimbeni, R.</creator><creator>Di Fabio, F.</creator><creator>Di Betta, E.</creator><creator>Salerni, B.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200901</creationdate><title>The changing impact of age on colorectal cancer surgery. A trend analysis</title><author>Nascimbeni, R. ; Di Fabio, F. ; Di Betta, E. ; Salerni, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4061-c133104c6b4482280c9bfa591e72320d32fcc90494ebba5dfd0de009aad60b573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colectomy - mortality</topic><topic>Colectomy - trends</topic><topic>colorectal cancer</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Elderly</topic><topic>Female</topic><topic>Hospitals, University - statistics &amp; numerical data</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Palliative Care - trends</topic><topic>Retrospective Studies</topic><topic>temporal trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nascimbeni, R.</creatorcontrib><creatorcontrib>Di Fabio, F.</creatorcontrib><creatorcontrib>Di Betta, E.</creatorcontrib><creatorcontrib>Salerni, B.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nascimbeni, R.</au><au>Di Fabio, F.</au><au>Di Betta, E.</au><au>Salerni, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The changing impact of age on colorectal cancer surgery. A trend analysis</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2009-01</date><risdate>2009</risdate><volume>11</volume><issue>1</issue><spage>13</spage><epage>18</epage><pages>13-18</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Objective  The aim of the study was to evaluate the changing influence of age on the outcomes of colorectal cancer surgery in a retrospective trend analysis. Methods  Data on 985 patients undergoing colorectal cancer surgery were collected during 1975–1984 and 1995–2004. Variables and outcomes of patients aged &lt; 65, 65–74, 75–84 and 85+ years were compared with intra‐ and interdecade analyses. Endpoints of the study were postoperative mortality, 5‐year overall and cancer‐related survivals. Results  The rate of elderly patients undergoing colorectal cancer surgery increased significantly from 1975–1984 to 1995–2004. Distribution of American Society of Anesthesiology score and cancer stage remained unchanged over time. The rate of palliative procedures decreased over time, most significantly in the older age groups. In 1995–2004 the palliation rate was similar across all age groups. The rate of emergency surgery also decreased, but it remained higher in older age groups. Operative mortality rate decreased over time across all age groups, but age‐related differences were still observed in the 1995–2004 series. Cancer‐related survival after curative surgery increased from 58% in 1975–1984 to 64% in 1995–2004 in 75+ years patients, while it increased from 56% to 78% in patients aged 74 years or younger. Conclusions  Elderly patients with colorectal cancer benefited substantially from healthcare progress during the last 30 years. The reduction of palliative procedures and the decline in operative mortality document the efficacy of not restricting the access to radical surgery for these patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18294264</pmid><doi>10.1111/j.1463-1318.2008.01491.x</doi><tpages>6</tpages></addata></record>
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subjects Age Factors
Aged
Aged, 80 and over
Colectomy - mortality
Colectomy - trends
colorectal cancer
Colorectal Neoplasms - surgery
Elderly
Female
Hospitals, University - statistics & numerical data
Humans
Italy - epidemiology
Kaplan-Meier Estimate
Male
Middle Aged
Palliative Care - trends
Retrospective Studies
temporal trends
title The changing impact of age on colorectal cancer surgery. A trend analysis
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