Shin Je-Wook, Park Byung Kwan, Kim Min Jung, Kim Bun, Kim Byung Chang, Park Sung Chan, Han Kyung Su, Sohn Dae Kyung, Oh Jae Hwan
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Ann Surg Treat Res. 2017 Apr;92(4):191-199. doi: 10.4174/astr.2017.92.4.191. Epub 2017 Mar 24.
The aim of this study was to investigate survival in patients aged ≥70 years who underwent colorectal cancer surgery in 2003 and 2009. In addition, we aimed to identify the factors that could affect survival in these patients.
In a cross-sectional study, a retrospective review of the data for 878 patients who underwent colorectal cancer surgery with curative intent in the years 2003 and 2009 was performed. The primary outcome was the 5-year overall survival rate (5-OSR), and the clinicopathologic factors that could affect overall survival were analyzed.
The 5-OSR was 77.8% and 84.9% in 2003 and 2009, respectively (P = 0.013). Age, American Society of Anesthesiologists physical status classification, stage, type of surgery, and length of hospital stay possibly affected survival per the univariate and multivariate analyses. In patients aged ≥70 years, the 5-OSR in 2009 was 75.9%, which showed improvement compared to 53.7% in 2003 (P = 0.027). The stage, type of surgery, and hospital stay were the variables that possibly affected survival in patients aged ≥70 years per the univariate analysis, whereas the stage (III; hazard ratio [HR], 2.188; P = 0.005) and length of hospital stay (>12 days; HR, 2.307; P = 0.004), were the variables that showed statistical significance on the multivariate analysis.
We found that early stage and shortening the length of hospital stay could affect survival in older patients with colorectal cancers. Because of limited evidence on the influence of shortening the length of hospital stay on survival in older patients, further investigations are warranted.
本研究旨在调查2003年和2009年接受结直肠癌手术的70岁及以上患者的生存率。此外,我们旨在确定可能影响这些患者生存率的因素。
在一项横断面研究中,对2003年和2009年878例接受根治性结直肠癌手术患者的数据进行回顾性分析。主要结局是5年总生存率(5-OSR),并分析可能影响总生存的临床病理因素。
2003年和2009年的5-OSR分别为77.8%和84.9%(P = 0.013)。单因素和多因素分析显示,年龄、美国麻醉医师协会身体状况分级、分期、手术类型和住院时间可能影响生存率。在70岁及以上患者中,2009年的5-OSR为75.9%,与2003年的53.7%相比有所提高(P = 0.027)。单因素分析显示,分期、手术类型和住院时间可能影响70岁及以上患者的生存率,而多因素分析显示,分期(III期;风险比[HR],2.188;P = 0.005)和住院时间(>12天;HR,2.307;P = 0.004)具有统计学意义。
我们发现早期阶段和缩短住院时间可能影响老年结直肠癌患者的生存率。由于关于缩短住院时间对老年患者生存率影响的证据有限,因此有必要进行进一步研究。