Medical and Surgical Management of Colorectal Cancer Emergencies in Elderly Patients

  • Filippo Landi
  • Eloy EspinEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


The incidence of CRC increases sharply with age. Complicated CRC is a predominant disease in elderly patients. Emergency presentation in the elderly is associated with higher rates of advanced disease. Risk of emergency admission is closely linked to advanced age, comorbidities, and well-identified socioeconomic factors. Colorectal resection for CRC in the elderly is a procedure that is frequently performed in an emergency situation and with important pre-existing comorbidity and reduced physiologic reserve. Complicated right-sided colon cancer is the most frequent indication for nonelective colorectal resection in the octogenarian. Frequently, in the setting of obstruction, perforation, or bleeding, colectomy is a lifesaving treatment and is associated with postoperative mortality up to 48% and morbidity up to 77%. Morbidity and mortality increase with age, comorbidities, and physical frailty. Elderly CRC patients undergoing resection have a greatly increased 1-year mortality risk, as well as worst mid- and long-term survival compared to elective patients of the same age. Chronological age should not be a contraindication for radical surgery, and a curative resection should be performed whenever allowed by disease stage or patient physical status. Palliative treatment may be necessary in up to a third of over 80 patients with complicated cancer.


Colorectal cancer Elderly patient Oldest old Emergency colorectal surgery Emergency presentation Nonelective colorectal resection 



Colon cancer


Colorectal cancer


Emergency colorectal resection


Emergency presentation




Modified frailty index


Morbidity and mortality


Rectal cancer


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Colorectal Surgery Unit, General Surgery ServiceHospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona (UAB)BarcelonaSpain

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