Personalized surgical management of colorectal cancer in elderly population

Colorectal cancer(CRC)in the elderly is extremely common but only a few clinicians are familiar with the complexity of issues which present in the geriatric population.In this phase of the life cycle,treatment is frequently suboptimal.Despite the fact that,nowadays,older people tend to be healthier...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2014-04, Vol.20 (14), p.3762-3777
Main Authors: Ugolini, Giampaolo, Ghignone, Federico, Zattoni, Davide, Veronese, Giacomo, Montroni, Isacco
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aging
cancer
Colorectal
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - surgery
Elderly
Frail Elderly
Geriatrics - methods
Humans
Laparoscopy
Medical Oncology - methods
Patient Care Team
Personalized
Polypharmacy
Postoperative Period
Quality of Life
Surgery
Topic Highlight
tre
Vulnerable Populations
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Summary:Colorectal cancer(CRC)in the elderly is extremely common but only a few clinicians are familiar with the complexity of issues which present in the geriatric population.In this phase of the life cycle,treatment is frequently suboptimal.Despite the fact that,nowadays,older people tend to be healthier than in previous generations,surgical undertreatment is frequently encountered.On the other hand,surgical overtreatment in the vulnerable or frail patient can lead to unacceptable postoperative outcomes with high mortality or persistent disability.Unfortunately,due to the geriatric patient being traditionally excluded from randomized controlled trials for a variety of factors(heterogeneity,frailty,etc.),there is a dearth of evidence-based clinical guidelines for the management of these patients.The objective of this review was to summarize the most relevant clinical studies available in order to assist clinicians in the management of CRC in the elderly.More than in any other patient group,both surgical and non-surgical management strategies should be carefully individualized in the elderly population affected by CRC.Although cure and sphincter preservation are the primary goals,many other variables need to be taken into account,such as maintenance of cognitive status,independence,life expectancy and quality of life.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v20.i14.3762