Risk factors for one-year mortality and the subsequent prognosis in older patients undergoing curative surgery for colorectal cancer: a retrospective multicenter study.

PURPOSE: Postoperative complications may affect the long-term outcomes after colorectal cancer (CRC) surgery. This multicenter study compared prognostic factors for overall survival (OS) in younger (≤ 74 years) and older (≥ 75 years) patients after curative resection for CRC, focusing on the 1-year and post-1-year outcomes.

METHODS

We analyzed data from 1582 patients who underwent curative surgery for CRC at six hospitals between April 2016 and December 2019. Kaplan-Meier and Cox models were used to identify the risk factors for complications and survival.

RESULTS

Older patients had a significantly worse overall survival (OS) and survival beyond the 1-year landmark. Postoperative complications were associated with increased 1-year mortality in both age groups. In younger patients, survival beyond 1 year was associated with a positive N status and a low BMI. In contrast, in older patients, postoperative complications remained associated with survival beyond the 1-year landmark, along with a male sex, positive N status, and poor ASA-PS.

CONCLUSIONS

The prolonged impact of complications on survival in older patients with CRC underscores the need for age-specific surgical strategies and proactive complication management.