Age ≥ 75 years was not significantly associated with major complications compared to younger patients after colorectal resection (14.0% vs. 8.8%; OR 1.73; 95% CI 0.79-3.94).
Cohort (n=272)
Does age ≥ 75 years worsen major complications or long-term oncologic outcomes in patients undergoing colorectal resection with primary anastomosis?
Chronological age ≥ 75 years alone is not associated with statistically significant differences in major complications or long-term oncologic outcomes after colorectal cancer resection with primary anastomosis, suggesting age alone should not preclude curative-intent surgery.
Effect estimate: OR 1.73 (95% CI 0.79-3.94)
Absolute Event Rate: 14% vs 8.8%
p-value: p=0.252
BACKGROUND: The impact of age on perioperative morbidity and long-term oncologic outcomes in colorectal cancer remains controversial. Although aging is linked to greater comorbidity and functional decline, advances in perioperative care have challenged the idea that older patients have worse outcomes. This study evaluated surgical and oncologic results in patients aged ≥ 75 years compared with younger individuals. METHODS: We conducted a retrospective cohort study including patients who underwent colorectal resection with primary anastomosis between 2015 and 2022. Patients were grouped by age (< 75 vs. ≥ 75 years) and matched 1:1 using propensity scores based on preoperative clinical and tumor-related variables. Major complications (Clavien-Dindo grade ≥ III) were analyzed using logistic regression, and OS and RFS were assessed using Kaplan-Meier curves and Cox proportional hazards models. RESULTS: Of 651 eligible patients, 272 were included in the matched cohort. No statistically significant differences were found between age groups in hospital stay (4.5 vs. 4.0 days; p = 0.270), reintervention (13.2% vs. 8.8%; p = 0.333), major complications (14.0% vs. 8.8%; p = 0.252), or 30-day perioperative mortality (3.7% vs. 0.7%; p = 0.216), although perioperative mortality was numerically higher among patients aged ≥ 75 years. Age ≥ 75 years was not significantly associated with major complications in multivariable analysis (OR 1.73; 95% CI 0.79-3.94). Five-year OS and RFS also did not differ significantly between groups. CONCLUSION: Older age was not associated with statistically significant differences in major complications or long-term oncologic outcomes in this matched cohort. However, clinically meaningful differences, particularly in short-term perioperative risk, cannot be excluded. Chronological age alone should not preclude curative-intent surgery.
Ramírez-Giraldo et al. (2026) conducted a cohort in Colorectal cancer (n=272). Age ≥ 75 years vs. Age < 75 years was evaluated on Major complications (Clavien-Dindo grade ≥ III) (OR 1.73, 95% CI 0.79-3.94, p=0.252). Age ≥ 75 years was not significantly associated with major complications compared to younger patients after colorectal resection (14.0% vs. 8.8%; OR 1.73; 95% CI 0.79-3.94).