Schlesinger-Raab Anne, Werner Jens, Friess Helmut, Hölzel Dieter, Engel Jutta
Munich Cancer Registry (MCR) of the Munich Cancer Centre (MCC), Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Klinikum der Universität München (KUM), Ludwig-Maximilians-University (LMU), Munich, Germany.
Department of Surgery, Klinikum der Universität München (KUM), Ludwig-Maximilians-University (LMU), Munich, Germany.
Visc Med. 2017 Aug;33(4):245-253. doi: 10.1159/000477104. Epub 2017 Aug 7.
With demographic changes and partial representativeness of randomized studies the question arises which results are achieved in the treatment of the elderly. The objective was to analyse population-based data on gastrointestinal cancers in terms of age.
Analyses included data of the Munich Cancer Registry, i.e. 4,014, 10,127 and 42,809 invasive oesophageal, gastric and colorectal cancer patients, respectively, which were diagnosed between 1998 and 2014. Tumour characteristics and outcome were analysed by age groups and therapy. Overall survival was analysed using the Kaplan-Meier method, and relative survival was computed as estimation for cancer-specific survival. Additionally, conditional survival of patients surviving at least 6 or 12 months was analysed by age.
21, 44 and 38% of oesophageal, gastric and colorectal cancer patients, respectively, were aged >75 years. Of these, 15, 46 and 73% were surgically treated with curative intent, respectively, which is significantly less than in younger patients. The total 5-year relative survival was 24, 33 and 66%, respectively. The differences in median survival by age group were diminished by selecting those surviving at least 6 or 12 months and those with curatively intended treatment.
An adequate patient selection for therapies of these gastrointestinal cancers was demonstrated at large. If the patients' general conditions allowed curatively intended treatment, it was applied and led to similar outcomes irrespective of age.
随着人口结构的变化以及随机研究的部分代表性,出现了关于老年患者治疗效果的问题。目的是按年龄分析基于人群的胃肠道癌症数据。
分析纳入了慕尼黑癌症登记处的数据,即分别在1998年至2014年期间诊断出的4014例、10127例和42809例浸润性食管癌、胃癌和结直肠癌患者。按年龄组和治疗方式分析肿瘤特征和预后。采用Kaplan-Meier法分析总生存期,并计算相对生存期作为癌症特异性生存期的估计值。此外,按年龄分析至少存活6个月或12个月的患者的条件生存期。
食管癌、胃癌和结直肠癌患者中,分别有21%、44%和38%的患者年龄>75岁。其中,分别有15%、46%和73%的患者接受了根治性手术治疗,这显著低于年轻患者。总的5年相对生存率分别为24%、33%和66%。通过选择至少存活6个月或12个月的患者以及接受根治性治疗的患者,各年龄组中位生存期的差异有所减小。
总体而言,这些胃肠道癌症治疗的患者选择是恰当的。如果患者的一般状况允许进行根治性治疗,无论年龄大小,都会进行这种治疗并取得相似的结果。