| [ Summary ] |
A critical decision point in the management of early colorectal cancer involves determining whether treatment can be accomplished by endoscopic resection alone or if it requires surgery. "Oldest‒old" patients frequently have multiple comorbidities, increasing their risk of surgical complications and, on occasion, their risk of mortality. In these patients, when endoscopic resection will not be curative for early colorectal cancer, the benefits and risks of surgery should be carefully considered.
Physicians should be familiar with the current average prognosis with early colorectal cancer and the expected prognosis of comorbidities with which "oldest‒old" patients are likely to be affected. In addition, the clinician's degree of diagnostic accuracy will greatly affect treatment strategy, such as endoscopic resection or various surgical modalities, including magnifying endoscopy and endoscopic ultrasonography. Finally, treatment decisions will be impacted by complication rates of endoscopic resection and surgery. Based on all available information described above, informed consent should outline the plan of treatment and the factors that were considered in the decision making process. |