Abstract
Purpose: To select an appropriate treatment for elderly patients with colon cancer, we must aim for rapid recovery to their preoperative state and carcinoma radicality. There are few reports on whether operative stress influences long survival. In this study, we examined the influence of surgical stress on long-term survival using the estimation of physiologic ability and surgical stress (E-PASS) scoring system. Method: The E-PASS scoring system was used to evaluate 83 patients aged ≥75 years who underwent colectomy with curative resection from the cecum to the rectosigmoid between January 2007 and December 2009 at our hospital. For this analysis, surgical stress was substituted for a comprehensive risk score (CRS) determined on the basis of both the preoperative risk score and a surgical stress score. The 83 patients were divided into the CRS-H group (comprehensive risk score-high, 0.252 or higher) and CRS-L group (comprehensive risk score-low, under 0.252), and both long-term and short-term outcomes were compared between the two groups. Results: Numerous postoperative complications were recorded for the CRS-H group; compared with the CRS-L group, fewer patients went home from the hospital, and the five-year overall survival was lower. Conclusion: This study demonstrated the utility of the E-PASS scoring system in predicting the long-term outcome of elderly patients with colon cancer.
