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80岁以上结直肠癌患者行结直肠癌切除术的安全性、可行性及长期预后评估。

Evaluation of safety, feasibility and the long-term outcomes of colorectomy for colorectal adenocarcinoma in patients older than 80 years of age.

作者信息

Yukawa Norio, Aoyama Toru, Sato Tsutomu, Oshima Takashi, Yoshikawa Takaki, Rino Yasushi, Masuda Munetaka

机构信息

Department of Surgery, Yokohama City University, Yokohama, Kanagawa 236-0004, Japan.

出版信息

Mol Clin Oncol. 2017 Oct;7(4):564-568. doi: 10.3892/mco.2017.1380. Epub 2017 Aug 18.

Abstract

The short- and long-term outcomes of colorectomy for colorectal adenocarcinoma have not been fully evaluated in elderly patients. The present retrospective study investigated patients who underwent curative surgery for colorectal cancer at the Department of Surgery, Yokohama City University (Yokohoma, Japan). The patients were categorized into two groups: Elderly patients (70-79 years of age; group A) and extremely elderly patients (≥80 years of age; group B). The rates of surgical morbidity, surgical mortality, overall survival (OS), and recurrence-free survival (RFS) in the two groups were compared. A total of 191 patients were evaluated in the current study. Of these, 137 patients were included in group A, and 54 were included in group B. With the exception of the American Society of Anesthesiology physical status score, there were no significant differences in the preoperative clinicopathological outcomes of the two groups. The overall complication rates in groups A and B were 12.4 and 16.7%, respectively, and did not differ to a statistically significant extent (P=0.440). In addition, surgical mortality was not observed in either group. The 5-year OS and RFS rates were similar between the group A and B patients (75.6 vs. 76.9%; P=0.5537; and 71.9 vs. 62.2%; P=0.192, respectively). The short-term outcomes and long-term survival following colorectomy for colorectal adenocarcinoma among patients in the 70-79 years of age group, and those who were ≥80 in the current study were almost equal. Thus, it is not necessary to avoid colorectomy for colorectal adenocarcinoma in elderly patients simply because of their age.

摘要

结直肠癌切除术治疗老年结直肠癌患者的短期和长期预后尚未得到充分评估。本回顾性研究调查了在日本横滨市立大学外科接受结直肠癌根治性手术的患者。患者分为两组:老年患者(70 - 79岁;A组)和高龄患者(≥80岁;B组)。比较了两组患者的手术并发症发生率、手术死亡率、总生存率(OS)和无复发生存率(RFS)。本研究共评估了191例患者。其中,137例患者纳入A组,54例纳入B组。除美国麻醉医师协会身体状况评分外,两组患者术前临床病理结果无显著差异。A组和B组的总体并发症发生率分别为12.4%和16.7%,差异无统计学意义(P = 0.440)。此外,两组均未观察到手术死亡。A组和B组患者的5年总生存率和无复发生存率相似(分别为75.6%对76.9%;P = 0.5537;以及71.9%对62.2%;P = 0.192)。本研究中70 - 79岁组患者和≥80岁患者行结直肠癌切除术后的短期预后和长期生存率几乎相等。因此,不必仅仅因为年龄而避免对老年结直肠癌患者进行结直肠癌切除术。

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