Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
J Surg Oncol. 2012 Feb;105(2):113-8. doi: 10.1002/jso.22019. Epub 2011 Jul 20.
The combined treatment of cytoreductive surgery (CRS) and perioperative chemotherapy (PIC) for colorectal peritoneal carcinomatosis (PC) is a rigorous surgical treatment most suited for fit and young patients. With technical maturity and improved perioperative care, we examined the outcomes of elderly patients undergoing CRS and PIC for colorectal PC.
All consecutive patients treated in two tertiary centers for PC of colorectal cancer who were 70 years of age or older at the time of surgery were included. Data on patient characteristics, concomitant diseases, operation details, perioperative course, and follow-up were retrieved from medical charts. Primary outcomes were perioperative morbidity and mortality. Secondary outcomes were disease-free and overall survival.
Twenty-four patients (11 male) were included in this study (mean age 73.5 years). In eight patients major complications occurred. In six patients the postoperative course was complicated by minor adverse events. There was no perioperative mortality. Median overall survival was 35 months with a 6, 12, and 18 months survival rate of 94%, 83%, and 68%, respectively.
CRS and PIC for colorectal PC may be safely performed with acceptable morbidity in selected elderly patients. When considering patients for surgery, performance status, and the disease extent should be used as eligibility criteria rather than age.
结直肠腹膜转移癌（PC）的细胞减灭术（CRS）联合围手术期化疗（PIC）是一种严格的手术治疗方法，最适合身体状况良好且年轻的患者。随着技术的成熟和围手术期护理的改善，我们检查了行 CRS 和 PIC 治疗结直肠 PC 的老年患者的结果。
纳入了在两个三级中心接受结直肠 PC 治疗的所有连续患者，这些患者在手术时年龄均为 70 岁或以上。从病历中检索了患者特征、合并症、手术细节、围手术期经过和随访的数据。主要结局是围手术期发病率和死亡率。次要结局是无病生存和总生存。
本研究纳入了 24 例患者（11 例男性）（平均年龄 73.5 岁）。8 例患者发生主要并发症。6 例患者术后病程中出现轻微不良事件。无围手术期死亡。中位总生存时间为 35 个月，6、12 和 18 个月的生存率分别为 94%、83%和 68%。
在选定的老年患者中，CRS 和 PIC 治疗结直肠 PC 可安全进行，且发病率可接受。在考虑手术患者时，应将身体状况和疾病程度作为入选标准，而不是年龄。
