AimThis study aimed to evaluate the association of age and postoperative morbidity on 5‐year overall survival (OS) after elective surgery for colorectal cancer.MethodPatients undergoing elective, curatively intended surgery for colorectal cancer Union for International Cancer Control Stages I–III between January 2014 and December 2019 were selected from four Danish nationwide healthcare databases. Patients were divided into four groups: group I 65–69 years old; group II 70–74 years old; group III 75–79 years old; and group IV ≥80 years old. Propensity score matching was used to reduce potential confounding bias. The primary outcome was the association of age and postoperative morbidity with 5‐year OS. The secondary outcome was conditional survival, given that the patient had already survived the first 90 days after surgery.ResultsAfter propensity score matching with a 1:1 ratio, group II contained 2221 patients; group III 952 patients; and group IV 320 patients. There was no significant difference in 5‐year OS between group I (reference) and groups II and III (P = 0.4 and P = 0.9, respectively). Patients with severe postoperative complications within 30 days after surgery had a significantly decreased OS (P < 0.01); however, when patients who died within the first 90 days were excluded from the analysis, the differences in 5‐year OS were less pronounced across all age groups.ConclusionPostoperative morbidity, and not patient age, was associated with a lower 5‐year OS. Long‐term survival for patients who experience a complication is similar to patients who did not have a complication when conditioning on 90 days of survival.

中文翻译：

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老年人结直肠手术后术后发病率和年龄与 5 年生存率的关系：一项全国性队列研究

目的本研究旨在评估年龄和术后发病率与结直肠癌择期手术后 5 年总生存期 (OS) 的关系。 方法 2014 年 1 月期间接受国际癌症控制联盟 I-III 期结直肠癌择期治愈性手术的患者2019 年 12 月和 2019 年 12 月是从四个丹麦全国医疗保健数据库中选出的。患者被分为四组：I组65-69岁；第二组70-74岁；第三组75-79岁；IV组≥80岁。倾向评分匹配用于减少潜在的混杂偏差。主要结局是年龄和术后发病率与 5 年 OS 的关系。次要结局是条件生存，考虑到患者在手术后的前 90 天就已经生存。结果 按照 1:1 的比例进行倾向评分匹配后，第 II 组包含 2221 名患者；III组952例患者；IV组320名患者。I 组（参考组）与 II 组和 III 组（参考组）之间的 5 年 OS 没有显着差异。磷= 0.4 和磷= 0.9，分别）。术后30天内出现严重术后并发症的患者OS显着下降（磷< 0.01); 然而，当在分析中排除前 90 天内死亡的患者时，所有年龄组的 5 年 OS 差异就不那么明显。 结论 术后发病率（而非患者年龄）与较低的 5 年 OS 相关。在 90 天生存条件下，出现并发症的患者的长期生存率与未出现并发症的患者相似。