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ABSTRACT

Colorectal cancer is predominantly a disease of older adults, yet age-related treatment decisions remain controversial. While chronological age is often used as a criterion for surgical eligibility, it remains unclear whether age alone is an independent predictor of surgical and oncological outcomes. This study evaluated whether age is a significant determinant of outcomes in colorectal cancer patients undergoing surgical resection. This retrospective comparative study analyzed 262 patients (193 younger than 70 years, 69 aged ≥ 70 years) diagnosed with colorectal cancer stages I-IV between 2014 and 2021 at a tertiary single center. Survival analysis was conducted using Kaplan-Meier method and Cox proportional hazards regression. Elderly patients had higher ASA classification (p = 0.0270), higher hypertension prevalence (p < 0.0001), higher ICU admission rates (50.7% vs. 21.2%, p < 0.0001), and longer hospital stays (12.6 vs. 7.5 days, p = 0.0016). However, elderly patients presented with earlier-stage disease (Stage I + II: 64.2% vs. 46.1%, p = 0.0108). After adjustment for confounding factors, age did not significantly impact overall survival (HR = 1.33; 95%CI: 0.54-3.26; p = 0.5375) or disease-free survival (HR = 1.61; 95%CI: 0.79-3.29; p = 0.1939). Despite differences in clinical presentation and pathological findings, age itself was not an independent predictor of survival outcomes. These findings suggest that treatment decisions in elderly colorectal cancer patients should be informed by individual patient physiology and disease stage rather than chronological age alone.

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