直肠癌治疗的结果——年龄的影响？

Outcomes of rectal cancer treatment--influence of age?

作者信息

Stornes T, Wibe A, Romundstad P R, Endreseth B H

机构信息

Department of Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, 7006, Norway,

出版信息

Int J Colorectal Dis. 2014 Jul;29(7):825-34. doi: 10.1007/s00384-014-1878-y. Epub 2014 May 6.

DOI:10.1007/s00384-014-1878-y

PMID:24798628

Abstract

PURPOSE

To evaluate how age influences the selection to different treatment modalities for rectal cancer and how these differences in approach affect the short- and long-term outcomes.

METHODS

A single-center cohort of all 837 rectal cancer patients diagnosed between 1994 and 2006 was analyzed. Patients <75, 75-79, 80-84, and >85 years were compared.

RESULTS

Treatment for cure was judged possible for 80.8, 77.9, 74.6, and 65.3 % of the four age groups (p = 0.02), and radiochemotherapy was given to 22.9, 19.3, 10.2, and 2 % of the same groups (p = 0.001). Local resection was performed for 3.7, 14.7, 13.6, and 24.5 % (p < 0.001) and anterior resection for 66.6, 54.1, 56.8, and 49 % (p < 0.001). The 5-year rates of local recurrence were 5.3, 8.3, 12.8, and 22.3 % (p < 0.001), and overall survival was 70, 54, 45.9, and 29.8 % in the four groups treated with curative intent (p < 0.001). Relative survival was 76.4, 72.6, 72.9, and 72.3 % (ns).

CONCLUSIONS

Age caused treatment to be modified; there was less surgery for patients over 85 years, less radiochemotherapy over 80 years, and less major radical surgery over 75 years. This strategy resulted in more local recurrences among the elderly, although no certain effect on relative survival was observed.

摘要

目的

评估年龄如何影响直肠癌不同治疗方式的选择，以及这些治疗方式的差异如何影响短期和长期疗效。

方法

分析了1994年至2006年间在单中心确诊的837例直肠癌患者的队列。对年龄小于75岁、75 - 79岁、80 - 84岁和大于85岁的患者进行了比较。

结果

四个年龄组中分别有80.8%、77.9%、74.6%和65.3%的患者被判定有可能进行根治性治疗（p = 0.02），相同组中分别有22.9%、19.3%、10.2%和2%的患者接受了放化疗（p = 0.001）。局部切除术的实施率分别为3.7%、14.7%、13.6%和24.5%（p < 0.001），前切除术的实施率分别为66.6%、54.1%、56.8%和49%（p < 0.001）。局部复发的5年率分别为5.3%、8.3%、12.8%和22.3%（p < 0.001），接受根治性治疗的四组患者的总生存率分别为70%、54%、45.9%和29.8%（p < 0.001）。相对生存率分别为76.4%、72.6%、72.9%和72.3%（无显著性差异）。