Abstract

FONSECA, Leonardo Maciel da; HANAN, Bernardo; NEIVA, Augusto Motta  and  SILVA, Rodrigo Gomes da. Treatment of colorectal cancer in extremely eldelry: case report and literature review. Rev bras. colo-proctol. [online]. 2010, vol.30, n.4, pp. 444-449. ISSN 0101-9880.  http://dx.doi.org/10.1590/S0101-98802010000400009.

Because the elderly population in Brasil is rapidly increasing, the colorectal surgeron will always manage extremely old patients, aged 75 or 85 years or older, with the diagnosis of colorectal cancer. The management of such cases is controversial. This paper reports the treatment of a 97-year-old patient with diagnosis of rectum adenocarcinoma, and presents a literature review on the best approach for old-age patients with colorectal cancer. The patient underwent a palliative laparoscopic retossigmoidectomy and colorectal anastomosis, as the specimen was resected through supra-pubic transverse incision. She was included in the fast-track rehabilitation program for colorectal surgery and had good recovery, being discharged in good clinical conditions on the third postoperative day. Pathologic examination of surgical specimen showed a rectum adenocarcinoma with invasion of the muscularis propria and metastasis in 2 of 12 dissected lymph nodes. According to the literature, in selected individuals older than 75 years, elective colorectal surgery for primary colorectal cancer can be performed with morbidity and mortality rates comparable to those of younger individuals, achieving favorable disease-free and overall long-term survival. Prognosis or contraindications to the procedure are not defined by isolate comorbidities.

Keywords : Colorectal neoplasms; health of the elderly; Colorectal surgery; Survival analysis; Mortality.