Objective   To investigate the effect of comorbid cardiovascular diseases on the perioperative period of colorectal cancer patients aged over 80 years.

  Methods   Clinicopathological data of 313 elderly patients aged over 80 years who underwent radical surgery for colorectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, from January 2007 to December 2018 were retrospectively collected and analyzed. Propensity score matching was used for 1: 1 matching of 10 covariates. Finally, 128 patients with comorbid cardiovascular diseases were matched with 128 patients without comorbid cardiovascular diseases. Perioperative indicators and postoperative complications were compared between the two groups.

  Result   Both groups were balanced in terms of baseline variables (all P>0.05). In terms of postoperative complications, there was no statistical difference between the two groups 37.5% (48/128) vs. 30.5% (39/128), P=0.235. According to the Clavien-Dindo classification of postoperative complications, the incidence of postoperative Clavien-Dindo Ⅳ complications in the comorbid cardiovascular disease group was significantly higher than that in the non- cardiovascular disease group 7.0% (9/128) vs. 1.6% (2/128), P=0.031. In terms of local surgical complications, the incidence of postoperative anastomotic leakage in patients with cardiovascular diseases was significantly higher than that in patients without cardiovascular diseases 7.8% (10/128) vs. 2.3% (3/128), P=0.046. In terms of other local surgical complications, there was no statistical difference between the two groups (all P> 0.05). In terms of non-surgical local complications, the incidence of postoperative blood circulatory system complications in patients with cardiovascular diseases was significantly higher thanthat in patients without cardiovascular diseases 10.2% (13/128) vs. 3.1% (4/128), P=0.024. There was no significant difference in the incidence of other non-surgical local complications between the two groups (all P>0.05).

  Conclusions   Comorbid cardiovascular diseases did not increase the risk of colorectal cancer surgery in patients aged over 80 years. However, it should be noted that the incidence of postoperative blood circulatory system complications and anastomotic leakage is significantly increased in elderly patients with cardiovascular diseases. For such patients, adequate preoperative evaluation, close postoperative monitoring, and the application of protective stoma are key to ensure that elderly patients with colorectal cancer can successfully survive the perioperative period.