TBA (16S171)

The Impact of Emergency Presentation of Colorectal Cancer and its Correlation with Increasing Age and Survival Outcomes

Author(s)

RM Waldron, ME Kelly, BM Molony, C Clancy MR Joyce, MJ Kerin

Department(s)/Institutions

Discipline of Surgery, Lambe Institute, NUI Galway

Introduction

Colorectal Cancer is one of the most common neoplasms. Reports have suggested that age and acute(emergency) presentation may be associated with poorer prognosis.

Aims/Background

To evaluate the composition of colorectal cancer presentation and the impact age has on survival.

Method

Using a single-centre tertiary referral institution database, a review of colorectal cancer operations was performed. Patient demographics, mode of presentation, and impact of age on survival were noted.

Results

A total of 506 patients underwent surgery for colorectal cancer between 2009–2013.  431(85.1%) were elective with 75(14.9%) presenting acutely. 83.2%(n=421) were under 80 years old. Median and 5-year overall survival was 40 months vs. 50 months and 66% vs. 43% for under 80 and over 80 year cohorts respectively(p=0.0005). 5-year survival for emergency colorectal resection in over 80 year cohort was 14%(p=0.001) as compared to 42.4% in elective patients greater than 40 years.

Conclusions

Overall 15% of colorectal resection are performed in octogenarians. Outcomes in the emergency setting are considerably poorer. Orthopaedic surgery have embraced the need for ortho-geriatrician. This study highlights the need for the development of surgical-geriatrician sub-specialty, to medically optimise elderly patients having complex surgery.