Nitsche Ulrich, Späth Christoph, Müller Tara C, Maak Matthias, Janssen Klaus-Peter, Wilhelm Dirk, Kleeff Jörg, Bader Franz G
Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany,
Int J Colorectal Dis. 2014 Aug;29(8):971-9. doi: 10.1007/s00384-014-1914-y. Epub 2014 Jun 13.
The incidence of colorectal cancer rises disproportionally in aging persons. With a shift towards higher population age in general, an increasing number of older patients require adequate treatment. This study aims to investigate differences between young and elderly patients who undergo resection for colorectal cancer, regarding clinical characteristics, morbidity, and prognosis.
By retrospective analysis of 6 years (2007 to 2012) of a prospectively documented database, a total of 636 patients were identified who underwent oncological resection for colorectal cancer at our institution. Of this total, all 569 patients with primary colorectal adenocarcinoma were included. Four hundred ten patients were 74 years or younger and 159 were 75 years or older. The median follow-up was 22 months.
Older patients had significantly more comorbidities (85 % vs. 56 %, p < 0.001) and a higher ASA score (p < 0.001). The mean length of stay in the hospital was longer (24 vs. 20 days, p = 0.002), as was the length of postoperative intensive care stay (4 vs. 2 days, p = 0.003). However, elderly patients did not have significantly higher rates of intraoperative complications or surgical morbidity. Tumor-specific 2-year survival was 83 ± 4 % for the elderly and 87 ± 2 % for the younger patients, which was not significantly different (p = 0.90).
Long-term outcome after oncologic resection for colorectal cancer does not differ between elderly and younger patients. Age in general should not be considered as a limiting factor for colorectal cancer surgery or tumor-specific prognosis.
结直肠癌的发病率在老年人中呈不成比例的上升。随着总体人口年龄向更高水平转变,越来越多的老年患者需要得到充分治疗。本研究旨在调查接受结直肠癌切除术的年轻患者和老年患者在临床特征、发病率和预后方面的差异。
通过对一个前瞻性记录数据库6年(2007年至2012年)的数据进行回顾性分析,确定了在我们机构接受结直肠癌肿瘤切除术的636例患者。其中,纳入了所有569例原发性结直肠腺癌患者。410例患者年龄在74岁及以下,159例患者年龄在75岁及以上。中位随访时间为22个月。
老年患者的合并症显著更多(85%对56%,p<0.001),美国麻醉医师协会(ASA)评分更高(p<0.001)。平均住院时间更长(24天对20天,p=0.002),术后重症监护停留时间也更长(4天对2天,p=0.003)。然而,老年患者术中并发症或手术发病率并没有显著更高。老年患者的肿瘤特异性2年生存率为83±4%,年轻患者为87±2%,差异无统计学意义(p=0.90)。
结直肠癌肿瘤切除术后的长期结局在老年患者和年轻患者之间没有差异。一般而言,年龄不应被视为结直肠癌手术或肿瘤特异性预后的限制因素。