Pasetto Lara Maria, Lise Mario, Monfardini Silvio
Istituto Oncologico Veneto, IRCCS: Medical Oncology 2nd, Via Gattamelata 64, 35128 Padova, Italy.
Crit Rev Oncol Hematol. 2007 Oct;64(1):10-8. doi: 10.1016/j.critrevonc.2007.08.001.
The incidence of most types of cancers is age-dependent and progressive ageing is rapidly increasing the number of elderly people who need treatment for cancer. It is an ethical dilemma how aggressive one should be when it comes to treating cancer in the older population. Presumed fear of increased postoperative morbidity and mortality often results in delivery of sub-optimal cancer surgery. A careful evaluation of the general and organ-related conditions of the patients is absolutely necessary for planning the right treatment. Nevertheless, preoperative removal of risk factors and postoperative rehabilitation are as important as the use of the best techniques of anaesthesia and surgery to achieve good postoperative outcomes in these patients. In this review article we take into consideration physiology of the aged and tools available to assess surgical risks in elderly patients, in the aim of increasing awareness on optimising surgical management of elderly patients with cancer. MEDLINE and EMBASE.com (search terms: "elderly", "preoperative", "surgery"), bibliographies of articles retrieved and the authors' reference files have been used as data sources. Independent extraction has been performed by the authors using predefined criteria, including study quality indicators.
大多数类型癌症的发病率与年龄相关，而人口老龄化迅速增加了需要接受癌症治疗的老年人数量。在老年人群中治疗癌症时，究竟应该采取多积极的治疗方式是一个伦理困境。对术后发病率和死亡率增加的担忧往往导致癌症手术治疗不够理想。为了规划正确的治疗方案，对患者的全身状况和器官相关状况进行仔细评估绝对必要。然而，术前消除危险因素和术后康复与采用最佳麻醉和手术技术以实现这些患者良好的术后效果同样重要。在这篇综述文章中，我们考虑了老年人的生理状况以及评估老年患者手术风险的可用工具，目的是提高对优化老年癌症患者手术管理的认识。MEDLINE和EMBASE.com（检索词：“老年人”、“术前”、“手术”）、检索到文章的参考文献以及作者的参考文件已被用作数据源。作者使用包括研究质量指标在内的预定义标准进行了独立提取。
