van Eeghen Elmer E, Bakker Sandra D, van Bochove Aart, Loffeld Ruud J L F
Zaans Medisch Centrum, Zaandam, The Netherlands.
J Gastrointest Oncol. 2015 Dec;6(6):605-12. doi: 10.3978/j.issn.2078-6891.2015.070.
Patients with colorectal cancer are often excluded from clinical trials based on age or a poor performance score. However, 70% of colorectal cancer is diagnosed in patients over 65. Evaluation on the influence of age and comorbidity on survival and cause of death in a non-selected population.
Included were 621 consecutive patients with colorectal cancer. An extensive chart review was performed for 392 patients with colon cancer and 143 patients with rectal cancer. Analyses were performed separately for both groups.
Median survival of colon cancer patients was 5.13 years, 131 patients (34.3%) died from tumour progression. Age and comorbidity were significant predictors for overall survival (P<0.001). Age was also a significant predictor of cause of death (P=0.001). In rectal cancer patients median survival was 4.67 years, 51 (35.7%) of patients died from tumour progression. Neither age nor comorbidity was significant predictors of survival. Age was a significant predictor of cause of death (P<0.001).
In colon cancer patient age and comorbidity predict survival. This represents possible bias or a reduced survival benefit of treatment, and is an indication that colon cancer is not the prognosis defining illness in the majority of patients. In rectal cancer patients neither age or comorbidity significantly impacted survival.
结直肠癌患者常因年龄或体能状态评分差而被排除在临床试验之外。然而，70%的结直肠癌是在65岁以上的患者中诊断出来的。评估年龄和合并症对非选择性人群生存及死亡原因的影响。
纳入621例连续的结直肠癌患者。对392例结肠癌患者和143例直肠癌患者进行了广泛的病历回顾。两组分别进行分析。
结肠癌患者的中位生存期为5.13年，131例患者（34.3%）死于肿瘤进展。年龄和合并症是总生存期的显著预测因素（P<0.001）。年龄也是死亡原因的显著预测因素（P=0.001）。直肠癌患者的中位生存期为4.67年，51例患者（35.7%）死于肿瘤进展。年龄和合并症均不是生存的显著预测因素。年龄是死亡原因的显著预测因素（P<0.001）。
在结肠癌患者中，年龄和合并症可预测生存。这可能代表了治疗中的偏差或生存获益降低，表明在大多数患者中，结肠癌并非决定预后的疾病。在直肠癌患者中，年龄和合并症均未显著影响生存。
