Emergency colorectal cancer in old and very elderly patients: a narrative review - Summary - MDSpire

Emergency colorectal cancer in old and very elderly patients: a narrative review

  • By

  • Carlo Bergamini

  • Jacopo Martellucci

  • Davina Perini

  • Paolo Prosperi

  • Alessio Giordano

  • May 15, 2026

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Objective:

To provide an evidence-based overview of colorectal cancer emergencies in patients aged ≥80 years, integrating surgical strategies with geriatric-oriented clinical reasoning for improved outcomes.

Key Findings:
  • Emergency CRC presentation occurs in up to 46% of colon cancers in patients older than 80 years, associated with worse survival outcomes, particularly due to frailty and comorbidity.
  • Malignant bowel obstruction is the most frequent emergency scenario.
  • Bridge-to-surgery strategies, such as self-expanding metal stents (SEMS) or diverting stomas, reduce early mortality compared to emergency resection in selected elderly patients.
  • Frailty and comorbidity burden are major independent prognostic determinants across all emergency presentations, significantly impacting treatment decisions.
Interpretation:

Management of emergency CRC in patients aged ≥80 years requires a balance between oncologic treatment and geriatric care, emphasizing individualized decision-making to align with patient-centered goals.

Limitations:
  • No formal risk-of-bias assessment was performed.
  • Limited evidence in some areas was acknowledged, which may affect clinical practice.
Conclusion:

Emergency CRC in patients aged ≥80 years necessitates geriatric-tailored surgical pathways and further research on frailty-based triage models and geriatric-focused care, highlighting the urgent need for these developments.

Original Source(s)

Emergency colorectal cancer in old and very elderly patients: a narrative review

  • by Carlo Bergamini, Jacopo Martellucci, Davina Perini, Paolo Prosperi, Alessio Giordano

  • May 15, 2026

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