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老年对接受实体瘤根治性手术治疗的患者的生存结局有影响。

Older age impacts on survival outcome in patients receiving curative surgery for solid cancer.

机构信息

Departments of Medical Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Nursing, Chang Gung Medical Foundation at Linkou, Linkou, Taiwan.

出版信息

Asian J Surg. 2018 Jul;41(4):333-340. doi: 10.1016/j.asjsur.2017.02.008. Epub 2017 Apr 17.

Abstract

BACKGROUND

Given the global increase in aging populations and cancer incidence, understanding the influence of age on postoperative outcome after cancer surgery is imperative. This study aimed to evaluate the impact of age on survival outcome in solid cancer patients receiving curative surgery.

METHODS

A total of 37,288 patients receiving curative surgeries for solid cancers between 2007 and 2012 at four affiliated Chang Gung Memorial Hospital were included in the study. All patients were categorized into age groups by decades for survival analysis.

RESULTS

The percentages of patient populations aged <40 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years were 9.7%, 17.7%, 27.8%, 22.1%, 16.9%, and 5.7%, respectively. The median follow-up period was 38.9 months (range, 22.8-60.4 months) and the overall, cancer-specific, and noncancer-specific mortality rates were 26.0%, 17.6%, and 8.5%, respectively. The overall mortality rate of patients in different age groups were 18.5%, 21.1%, 22.0%, 25.3%, 35.3%, and 49.0%, respectively. Compared to patients aged <40 years, more significant decrease in long-term survival were observed in aging patients. Multivariate analysis showed higher postoperative short-term mortality rates in patients older than 70 years, and the adjusted odds ratio of mortality risk ranged from 1.47 to 1.74 and 2.26 to 3.03 in patients aged 70-79 years and ≥80 years, respectively, compared to those aged <40 years.

CONCLUSION

Aging was a negative prognostic factor of survival outcome in solid cancer patients receiving curative surgery. After adjustment of other clinicopathologic factors, the influence of age on survival outcome was less apparent in the elderly.

摘要

背景

鉴于全球人口老龄化和癌症发病率的增加,了解年龄对癌症手术后的生存结果的影响至关重要。本研究旨在评估年龄对接受根治性手术的实体癌患者生存结果的影响。

方法

本研究共纳入 2007 年至 2012 年在长庚纪念医院四个附属医院接受根治性手术治疗的 37288 例实体癌患者。所有患者均按年龄分为十年组进行生存分析。

结果

年龄<40 岁、40-49 岁、50-59 岁、60-69 岁、70-79 岁和≥80 岁的患者比例分别为 9.7%、17.7%、27.8%、22.1%、16.9%和 5.7%。中位随访时间为 38.9 个月(22.8-60.4 个月),总生存率、癌症特异性生存率和非癌症特异性生存率分别为 26.0%、17.6%和 8.5%。不同年龄组患者的总死亡率分别为 18.5%、21.1%、22.0%、25.3%、35.3%和 49.0%。与<40 岁患者相比,年龄较大的患者长期生存率显著下降。多变量分析显示,70 岁以上患者术后短期死亡率较高,调整后的死亡风险比在 70-79 岁和≥80 岁患者中分别为 1.47-1.74 和 2.26-3.03,与<40 岁患者相比。

结论

在接受根治性手术的实体癌患者中,衰老为生存结果的一个负面预后因素。在调整其他临床病理因素后,年龄对生存结果的影响在老年人中不明显。

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