Department of Geriatric Gastroenterology, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
Department of Pathology, Guizhou Medical University Hospital, Guiyang, 550004, Guizhou, People's Republic of China.
Support Care Cancer. 2018 Jul;26(7):2333-2339. doi: 10.1007/s00520-018-4065-9. Epub 2018 Feb 7.
Treatment and management of cancers in elderly patients require some special considerations. A better understanding of how cancers progress in those elderly patients who have not received any anticancer treatments could better help us in treating these patients and in making end-of-life decisions. Over the past years, we had encountered 57 elderly patients, aged 75 to 94 years (87.6 on average), with a cancer in the digestive system, who refused to accept anticancer treatment but who did receive the best available supportive and palliative care. Clinicopathological data of these patients were analyzed. Of these 57 cases, 49 were at an advanced or late stage, while the remaining eight were at an early stage at the time of diagnosis. The median overall survival time of all the patients was 11 months, and almost the entire cohort manifested multiple-organ impairments. The average number of malfunctioning organs per patient was 3.68. After carefully predicting, and then preventing or managing complications, only 54.4% of the patients eventually died of multiple-organ functional failure. Nearly 18% of the single organ dysfunctions were finally well-controlled. Our data provide the first statistical information on the survival time and the direct cause of death of the elderly patients with a cancer in the digestive system not treated with chemotherapy or other direct anticancer interventions, but who did receive the best available supportive and palliative cares. During their struggle with cancer, elderly patients clearly could benefit from prophylactic interventions on organ dysfunction.
治疗和管理老年癌症患者需要一些特殊的考虑。更好地了解未接受任何抗癌治疗的老年患者中癌症的进展情况，可以帮助我们更好地治疗这些患者并做出临终决策。在过去的几年中，我们遇到了 57 名年龄在 75 至 94 岁之间（平均年龄为 87.6 岁）的老年癌症患者，他们拒绝接受抗癌治疗，但接受了最佳的支持性和姑息性治疗。分析了这些患者的临床病理数据。在这 57 例中，有 49 例处于晚期或晚期，而其余 8 例在诊断时处于早期。所有患者的中位总生存时间为 11 个月，几乎所有患者均表现出多器官损伤。每位患者平均有 3.68 个器官功能障碍。经过仔细预测，然后预防或管理并发症后，只有 54.4%的患者最终死于多器官功能衰竭。近 18%的单一器官功能障碍最终得到很好的控制。我们的数据提供了第一个关于未接受化疗或其他直接抗癌干预的消化系统癌症老年患者的生存时间和直接死亡原因的统计信息，但他们接受了最佳的支持性和姑息性治疗。在与癌症作斗争的过程中，老年患者显然可以从器官功能障碍的预防性干预中受益。
