Outcomes Following Colorectal Cancer Resection in Elderly Patients
by
, ,
Richard Grainger
1,†, 
Tatiana S. Temperley
1,†,
Hugo C. Temperley
1,2,3,*,
Ben Creavin
1,
Emily Harrold
4,
Cillian Clancy
1,
James O’Riordan
1,
David Gallagher
4,5,
Brian J. Mehigan
1,
John Larkin
1,
Charles Gillham
6,
Dara Kavanagh
1,
Paul H. McCormick
1 and
Michael E. Kelly
1,3,* 1
Department of Surgery-Trinity college Dublin/St James Hospital Dublin Ireland D08 NHY1 Dublin, Ireland
2
Department of Radiology, St. James’s Hospital, D08 NHY1 Dublin, Ireland
3
Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland
4
Department of Medical Oncology, St. James’s Hospital, D08 NHY1 Dublin, Ireland
5
Department of Genetics, St. James’s Hospital, D08 NHY1 Dublin, Ireland
6
Department of Radiation Oncology, St. James’s Hospital, D08 NHY1 Dublin, Ireland
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Curr. Oncol. 2025, 32(12), 652; https://doi.org/10.3390/curroncol32120652
Submission received: 16 October 2025
/
Revised: 3 November 2025
/
Accepted: 17 November 2025
/
Published: 21 November 2025
(This article belongs to the Special Issue Advances in Geriatric Oncology: Toward Optimized Cancer Care)
Simple Summary
Colorectal cancer is a common disease in older adults, but older patients are often not included in research studies. As a result, we do not always know how well they recover after surgery or which factors predict a difficult recovery. In this study, we looked at over 200 patients aged 75 and older who had surgery for colorectal cancer at a large hospital in Ireland. We collected information about their health before surgery, the type of operation they had, and how they did afterwards. We found that surgery was generally safe, even for older patients. However, people with more medical conditions were more likely to have serious problems after surgery or to die within 30 days. We also found that patients who had laparoscopic (keyhole) surgery tended to recover better. Our findings show that age alone should not stop someone from having potentially life-saving surgery. Instead, doctors should consider the patient’s overall health. This information can help doctors and patients make better decisions together and may lead to more older adults being offered treatment that can improve their survival and quality of life.
Abstract
Background: Colorectal cancer (CRC) mainly affects older adults, yet elderly patients are underrepresented in outcomes research. Accurate risk stratification tools, such as the Charlson Comorbidity Index (CCI), are essential for guiding surgical decisions in this group. Methods: We conducted a retrospective review of patients aged 75 years or older who underwent colorectal cancer resection at a tertiary centre between January 2019 and September 2024. Clinical, pathological, and molecular data were analyzed. The primary outcome was a composite of major postoperative complications (Clavien–Dindo grade 3 or higher) or 30-day mortality, stratified by CCI (5 or higher vs. less than 5). Statistical tests included chi-square, Fisher’s exact, and Mann–Whitney U as appropriate. Results: The median age was 81 years (range 75–97), with 59.7% male. CCI ≥ 5 was observed in 24.6% (51/211). The primary composite outcome of major postoperative complications or 30-day mortality occurred in 15/51 (29.4%) patients with a CCI ≥ 5 compared to 19/160 (11.9%) with a CCI < 5 (p = 0.04). Major complications occurred in 18.5% (39/211) of cases, and the 30-day mortality rate was 3.3% (7/211). Laparoscopic resection was independently protective in multivariate analysis (adjusted OR 0.37, p = 0.048), while age ≥85 and emergency presentation were not statistically significant predictors. Conclusions: Colorectal resection in patients aged ≥75 is linked with acceptable morbidity and low short-term death rates. A CCI ≥ 5 significantly predicts adverse outcomes and should be included in preoperative assessments. Minimally invasive surgery seems advantageous and should be considered, when possible, to enhance results in this high-risk group.
