老年胃癌的临床与预后情况

Clinical and prognostic aspects of gastric carcinoma in the elderly.

作者信息

Gasparini Giulia, Inelmen Emine Meral, Enzi Giuliano, Santoro Cristina, Sergi Giuseppe, Cardin Fabrizio, Terranova Oreste

机构信息

Department of Medical and Surgical Sciences, Geriatrics Section, University of Padua, Ospedale Giustinaneo 2 piano, Via Giustiniani 2, 35100 Padua, Italy.

出版信息

J Gastrointest Surg. 2006 Mar;10(3):395-401. doi: 10.1016/j.gassur.2005.07.002.

DOI:10.1016/j.gassur.2005.07.002

PMID:16504885

Abstract

The aim of the present study was to analyze the influence of various factors on the prognosis for elderly patients with gastric carcinoma. Forty-eight patients aged > or =65 years admitted to Padova General Hospital were divided into two groups by age (<75 or >75 years). They all had a histologically confirmed diagnosis of gastric adenocarcinoma. Information on their clinicopathological characteristics was collected from the Padova Hospital medical records. On univariate analysis, significant prognostic factors in the two age groups were gender, stage, histotype (Lauren's intestinal type), Charlson index, and type of surgery (curative resection, palliative resection, and no surgery). On multivariate analysis, independent prognostic factors were the Charlson index, tumor stage, and age group. The 52-month survival rate was 72.7% for females and 12.5% for males for patients > or =75 years (P = 0.01), while for the whole series of patients it was 67.5% for females and 29.9% for males (P = 0.003). The 17-month survival rate was 55.6% for surgically treated patients and 0% for the untreated cases in stage 4 (P = 0.03). Gastric cancer should be treated with conventional surgery even in the very elderly, since the survival rate for this age group does not differ significantly from the figures for younger patients.

摘要

本研究的目的是分析各种因素对老年胃癌患者预后的影响。帕多瓦综合医院收治的48例年龄≥65岁的患者按年龄（<75岁或>75岁）分为两组。他们均经组织学确诊为胃腺癌。从帕多瓦医院的病历中收集了他们的临床病理特征信息。单因素分析显示，两个年龄组的显著预后因素为性别、分期、组织学类型（劳伦肠型）、查尔森指数和手术类型（根治性切除、姑息性切除和未手术）。多因素分析显示，独立预后因素为查尔森指数、肿瘤分期和年龄组。≥75岁患者中，女性52个月生存率为72.7%，男性为12.5%（P = 0.01），而在整个患者系列中，女性为67.5%，男性为29.9%（P = 0.003）。4期手术治疗患者的17个月生存率为55.6%，未治疗患者为0%（P = 0.03）。即使是高龄患者，胃癌也应采用传统手术治疗，因为该年龄组的生存率与年轻患者相比无显著差异。