Chronological age and failure to rescue after colorectal cancer surgery: A multicentre cohort study.
8 affiliations
- 1Department of General Surgery and Surgical Oncology, Saint Wojciech Hospital, Nicolaus Copernicus Health Center, Gdańsk, Poland.
- 2Department of Oncology and Haematology, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland.
- 3First Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.
- 4Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Toruń, Poland.
- 5Department of Oncological Surgery, Gdynia Oncology Centre, Gdynia, Poland.
- 6Department of Oncological Surgery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdańsk, Poland.
- 7Department of Minimally Invasive and Oncological General Surgery, Voivodeship Hospital in Bialystok, Bialystok, Poland.
- 8Department of Surgery, Dnipro State Medical University, Vernadskoho st 9, Dnipro, 49044, Ukraine. [email protected].
Abstract
Background
Whether advancing chronological age is associated more strongly with serious postoperative events or with survival after an event remains uncertain.Aims
To compare the association of chronological age with major postoperative events and failure to rescue after colorectal cancer surgery.Methods
We analyzed 1,124 adults treated at five Polish centers between January 2022 and August 2025. Major events were Clavien-Dindo ≥grade IIIa; failure to rescue was cumulative 90-day death after such an event. Chronological age was analysed per 10-year increase. Multivariable logistic regression examined major events and Firth regression examined failure to rescue.Results
Major events occurred in 145 patients; failure to rescue was evaluable in 134 and occurred in 24. Chronological age was not associated with major events (adjusted odds ratio per decade 1.09, 95% confidence interval 0.89-1.33) or nonfatal major morbidity. Failure-to-rescue odds increased per decade (odds ratio 2.02, 95% confidence interval 1.21-3.63); model-standardized probabilities were 11.1% at age 65 and 32.5% at age 85 years. Sensitivity analyses were directionally consistent, but the interval included no association when every model-eligible missing post-event outcome was assigned to death.Discussion
The chronological-age gradient was concentrated in survival after a serious event. Frailty and physiological reserve were not measured; reduced reserve remains a plausible explanation rather than a demonstrated mechanism.Conclusions
Chronological age may help identify patients who warrant intensified postoperative surveillance and early escalation, while formal geriatric and frailty assessment remains necessary to characterize biological vulnerability.
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BibTeX
@article{cwalinski2026chronological,
title = {{Chronological age and failure to rescue after colorectal cancer surgery: A multicentre cohort study.}},
author = {Tomasz Cwaliński and Michał Kazanowski and Jacek Piątkowski and Maciej Ciesielski and Marcin Januszkiewicz and Zuzanna Bigus and Patryk Kaczor and Bartosz Kapturkiewicz and Paweł Lesiak and Sergii Girnyi and Damian Nowiński and Piotr Kurek and Marek Jackowski and Marek Bębenek and Mateusz Jagielski and Luigi Marano},
journal = {Aging clinical and experimental research},
year = {2026},
month = sep,
doi = {10.1007/s40520-026-03508-y},
url = {https://europepmc.org/article/MED/42858222},
note = {CC BY},
}
RIS
TY - JOUR
TI - Chronological age and failure to rescue after colorectal cancer surgery: A multicentre cohort study.
AU - Tomasz Cwaliński
AU - Michał Kazanowski
AU - Jacek Piątkowski
AU - Maciej Ciesielski
AU - Marcin Januszkiewicz
AU - Zuzanna Bigus
AU - Patryk Kaczor
AU - Bartosz Kapturkiewicz
AU - Paweł Lesiak
AU - Sergii Girnyi
AU - Damian Nowiński
AU - Piotr Kurek
AU - Marek Jackowski
AU - Marek Bębenek
AU - Mateusz Jagielski
AU - Luigi Marano
PY - 2026
DA - 2026/09/07
JO - Aging clinical and experimental research
DO - 10.1007/s40520-026-03508-y
UR - https://europepmc.org/article/MED/42858222
AB - Background Whether advancing chronological age is associated more strongly with serious postoperative events or with survival after an event remains uncertain.Aims To compare the association of chronological age with major postoperative events and failure to rescue after colorectal cancer surgery.Methods We analyzed 1,124 adults treated at five Polish centers between January 2022 and August 2025. Major events were Clavien-Dindo ≥grade IIIa; failure to rescue was cumulative 90-day death after such an event. Chronological age was analysed per 10-year increase. Multivariable logistic regression examined major events and Firth regression examined failure to rescue.Results Major events occurred in 145 patients; failure to rescue was evaluable in 134 and occurred in 24. Chronological age was not associated with major events (adjusted odds ratio per decade 1.09, 95% confidence interval 0.89-1.33) or nonfatal major morbidity. Failure-to-rescue odds increased per decade (odds ratio 2.02, 95% confidence interval 1.21-3.63); model-standardized probabilities were 11.1% at age 65 and 32.5% at age 85 years. Sensitivity analyses were directionally consistent, but the interval included no association when every model-eligible missing post-event outcome was assigned to death.Discussion The chronological-age gradient was concentrated in survival after a serious event. Frailty and physiological reserve were not measured; reduced reserve remains a plausible explanation rather than a demonstrated mechanism.Conclusions Chronological age may help identify patients who warrant intensified postoperative surveillance and early escalation, while formal geriatric and frailty assessment remains necessary to characterize biological vulnerability.
SN - 1594-0667
SN - 1720-8319
ER -