Characteristics of colorectal cancer in the elderly patients about 60 cases

Introduction: Older people constitute a heterogeneous population, according to World Health Organization, the elderly person is defined as any individual with a chronological age equal to or higher than 60 years. In most cases, colorectal carcinoma is a disease of the elderly. Occurs mostly in the elderly people of more than 65 years and it poses public health problem. For several years geriatric evaluation has shown multiple benefits and we are witnessing a significant improvement in the oncological management of these patients. Methods: This is a retrospective study conducted in the Medical Oncology Department CHU Tlemcen for patients aged 65 years and over with colorectal carcinoma. The objective of this study is the geriatric evaluation before treatment and establish the different epidemiological, clinical, endoscopic, histological and therapeutic profile of colorectal cancer and survival without recurrence in this population. Results: We collected 60 cases of which 56% were men. The mean age was 71.3 years [65-91], The majority of patients had comorbidities associated with diabetes (20%), hypertension (34%), heart disease (8%) and 38% had others, 18% had a family history of cancers. The mean time to consultation was 9.1 months [1-36], The reason for consultation was rectorrhagia (45%), abdominal pain (25%), constipation (11%), diarrhea (10%) and occlusive syndrome (8%). Endoscopic appearance of the tumor was dominated by the burgeoning ulcerative appearance in the majority of cases, the tumour was colic in 72%. The well differentiated lieberkuhnal adenocarcinoma was the dominant histological type (89%). Tumor resection with node dissection was performed in 80% of cases. The tumor was classified as stage I (14%), II (14%), III (47%) and IV (25%). The metastases were synchronous at diagnosis in 25% of cases and metachronous in 15%, they were liver metastases (42%), peritoneal carcinomatosis (27%), pulmonary (21%) and other (10%). Before treatment evaluating oncogeriatric was done in patients older than 75 years the score G8 was superior than 14 in 69% of cases which 28% were classified as fragile according to BALDUCCI. The toxicity score of HURRIA was low for standard dose monochemotherapy in 46%. 51% of patients had an indication of adjuvant chemotherapy however only 45% received the recommended protocol. The evolution was marked by 15% of recurrences and 36% of deaths. Conclusion: Elderly patients with colorectal cancer deserve to be treated in the same way as younger subjects. These treatments must be targeted and adapted according to age and associated co-morbidities, only a collaboration of oncologists and geriatricians strengthened in a multidisciplinary consultation that will facilitate the care of these patients.