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.
