British journal of cancer · 2026
The effect of older age and stage on risk of recurrence and mortality following curative resection, in a national cohort of patients with colorectal cancer.
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Almilaji Orouba, Walker Kate, Van Der Meulen Jan, Fearnhead Nicola, Braun Michael, Sharples Linda D
Аннотация
BACKGROUND: Older patients are routinely excluded from clinical research, limiting understanding of recurrence and mortality in colorectal cancer (CRC) patients over 75 who undergo curative major resection.
METHODS: Using linked data from national cancer, treatment and administrative datasets, we estimated recurrence, CRC-related and non-CRC mortality to 5 years after surgery for patients selected for curative resection in England between 2014 and 2020, who survived >9months. Recurrence was defined using diagnostic and treatment codes.
RESULTS: 50,480 patients had curative resection, 15,496 (30.7%) aged >75. Recurrence-free survival at 5-years after resection was 66.2% (95%CI: 65.4%, 67.0%) for patients aged >75 and 77.4% (77.0%, 77.9%) for patients aged 18-75. By 5-years, 13.3% (12.7%, 13.9%) of the older group had died from CRC and 14.2% (13.6%, 14.8%) from non-CRC causes, compared with 7.7% (7.4%, 8.0%) and 3.6% (3.4%, 3.8%) respectively in the younger group. Recurrence-free survival was 22% lower for cancer stage 3 versus stage 1, and 12-13% lower for patients aged >75 versus ≤75.
CONCLUSIONS: Cancer stage was the strongest predictor of recurrence and CRC-related death. In patients selected for surgery, those aged>75 had similar recurrence risk to younger patients, but higher risk of death following recurrence, and were as likely to die from other causes as from CRC.
METHODS: Using linked data from national cancer, treatment and administrative datasets, we estimated recurrence, CRC-related and non-CRC mortality to 5 years after surgery for patients selected for curative resection in England between 2014 and 2020, who survived >9months. Recurrence was defined using diagnostic and treatment codes.
RESULTS: 50,480 patients had curative resection, 15,496 (30.7%) aged >75. Recurrence-free survival at 5-years after resection was 66.2% (95%CI: 65.4%, 67.0%) for patients aged >75 and 77.4% (77.0%, 77.9%) for patients aged 18-75. By 5-years, 13.3% (12.7%, 13.9%) of the older group had died from CRC and 14.2% (13.6%, 14.8%) from non-CRC causes, compared with 7.7% (7.4%, 8.0%) and 3.6% (3.4%, 3.8%) respectively in the younger group. Recurrence-free survival was 22% lower for cancer stage 3 versus stage 1, and 12-13% lower for patients aged >75 versus ≤75.
CONCLUSIONS: Cancer stage was the strongest predictor of recurrence and CRC-related death. In patients selected for surgery, those aged>75 had similar recurrence risk to younger patients, but higher risk of death following recurrence, and were as likely to die from other causes as from CRC.