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.

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. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

Personalized surgical management of colorectal cancer in elderly population / Ugolini G;Ghignone F;Zattoni D;Veronese G;Montroni I. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - STAMPA. - 20:14(2014), pp. 3762-3777. [10.3748/wjg.v20.i14.3762]

Personalized surgical management of colorectal cancer in elderly population

UGOLINI, GIAMPAOLO;GHIGNONE, FEDERICO;ZATTONI, DAVIDE;VERONESE, GIACOMO;MONTRONI, ISACCO
2014

Abstract

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. © 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
2014
Personalized surgical management of colorectal cancer in elderly population / Ugolini G;Ghignone F;Zattoni D;Veronese G;Montroni I. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - STAMPA. - 20:14(2014), pp. 3762-3777. [10.3748/wjg.v20.i14.3762]
Ugolini G;Ghignone F;Zattoni D;Veronese G;Montroni I
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/396884
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