Liang Jian-wei, Bai Xiao-feng, Zhou Zhi-xiang, Zhao Dong-bing, Wang Cheng-feng, Zhao Ping
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2008 Jun 3;88(21):1467-70.
To evaluate the prognostic factors of colorectal carcinoma in the elderly aged over 70 after radical surgery.
263 colorectal carcinoma patients aged 74.9, 147 males and 115 females, underwent radical surgery, including right hemicolectomy (n=48), left hemicolectomy (n=11), transverse colectomy (n=8), sigmoid resection (n=27), low anterior resection (n=103), abdominoperineal resection (n=58), and Hartmann's operation (n=7). Survival analysis was conducted using Kaplan-Meier method, and multivariate analysis was conducted with Cox regression to analyze the prognostic factors.
The post-operative complication rate was 14. 4%. The 30-day mortality was 1.1%. The overall 5-year survival rate was 70.5%, and the 5-year survival rates of the patients with ASA grades I, II, and III were 84.8%, 71.8%, and 61.9% respectively. Univariate analysis showed that the predictors of survival were age, co-morbidity, ASA score, postoperative complication, preoperative serum albumin concentration, preoperative hemoglobin level, gross tumor configuration, tumor stage, neoplastic intestinal obstruction, and lymph node metastasis. Multivariate analysis showed that patient sex, complication, operative complication, gross tumor configuration, depth of infiltration, lymph node metastasis, and tumor staging were independent influencing factors od prognosis.
The prognosis of colorectal carcinoma in the elderly after radical surgery is good. The prognostic factors include age, postoperative complication, and pre-operative serum albumin concentration, and gross tumor configuration, depth of tumor invasion, lymph node metastasis, and tumor stage.
评估70岁以上老年结直肠癌患者根治性手术后的预后因素。
263例年龄为74.9岁的结直肠癌患者(男性147例,女性115例)接受了根治性手术,包括右半结肠切除术(n = 48)、左半结肠切除术(n = 11)、横结肠切除术(n = 8)、乙状结肠切除术(n = 27)、低位前切除术(n = 103)、腹会阴联合切除术(n = 58)和哈特曼手术(n = 7)。采用Kaplan-Meier法进行生存分析,并用Cox回归进行多因素分析以分析预后因素。
术后并发症发生率为14.4%。30天死亡率为1.1%。总体5年生存率为70.5%,美国麻醉医师协会(ASA)分级为I、II和III级的患者5年生存率分别为84.8%、71.8%和61.9%。单因素分析显示,生存的预测因素为年龄、合并症、ASA评分、术后并发症、术前血清白蛋白浓度、术前血红蛋白水平、肿瘤大体形态、肿瘤分期、肿瘤性肠梗阻和淋巴结转移。多因素分析显示,患者性别、并发症、手术并发症、肿瘤大体形态、浸润深度、淋巴结转移和肿瘤分期是预后的独立影响因素。
老年结直肠癌患者根治性手术后预后良好。预后因素包括年龄、术后并发症、术前血清白蛋白浓度、肿瘤大体形态、肿瘤浸润深度、淋巴结转移和肿瘤分期。