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80岁以上结直肠癌患者的肿瘤学结局:一项倾向评分匹配分析。

Oncologic outcome of colorectal cancer patients over age 80: a propensity score-matched analysis.

作者信息

Oh Bo Young, Huh Jung Wook, Kim Hee Cheol, Park Yoon Ah, Cho Yong Beom, Yun Seong Hyeon, Lee Woo Yong, Chun Ho-Kyung

机构信息

Department of Surgery, College of Medicine, Ewha Womans University, Seoul, South Korea.

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.

出版信息

Int J Colorectal Dis. 2018 Aug;33(8):1011-1018. doi: 10.1007/s00384-018-3028-4. Epub 2018 Mar 21.

Abstract

PURPOSE

It remains unclear whether old age is a poor prognostic factor in colorectal cancer (CRC). We compared oncologic outcomes in CRC patients according to age, using 80 as the dividing point.

METHODS

CRC patients who underwent radical surgery from 2000 to 2011 were evaluated. We performed matched and adjusted analyses comparing oncologic outcomes between patients with ≥ 80 and < 80 years old.

RESULTS

Among 9562 patients, 222 were elderly. The median age was 82.0 years in elderly patients and 59.0 years in young patients. Elderly patients received less neoadjuvant or adjuvant therapy compared to young patients (p < 0.001). After recurrence, significantly fewer elderly patients received additional treatments (p < 0.001). Before matching, disease-free survival (DFS) and cancer-specific survival (CSS) were significantly lower for elderly patients compared to those for young patients (p < 0.001 and p < 0.001, respectively). After matching, DFS and CCS were not significantly different between the two groups (p = 0.400 and p = 0.267, respectively). In a multivariate analysis for prognostic factors, old age was not an independent poor prognostic factor of DFS and CCS (p = 0.619 and p = 0.137, respectively).

CONCLUSIONS

Elderly patients aged ≥ 80 years with CRC had similar oncologic outcome to young patients, and age was not an independent prognostic factor.

摘要

目的

老年是否为结直肠癌(CRC)的不良预后因素仍不明确。我们以80岁为分界点,比较了CRC患者的肿瘤学结局。

方法

对2000年至2011年接受根治性手术的CRC患者进行评估。我们进行了匹配和调整分析,比较了年龄≥80岁和<80岁患者之间的肿瘤学结局。

结果

在9562例患者中,222例为老年患者。老年患者的中位年龄为82.0岁,年轻患者为59.0岁。与年轻患者相比,老年患者接受新辅助或辅助治疗的较少(p<0.001)。复发后,接受额外治疗的老年患者明显较少(p<0.001)。在匹配前,老年患者的无病生存期(DFS)和癌症特异性生存期(CSS)明显低于年轻患者(分别为p<0.001和p<0.001)。匹配后,两组之间的DFS和CCS无显著差异(分别为p = 0.400和p = 0.267)。在预后因素的多变量分析中,老年不是DFS和CCS的独立不良预后因素(分别为p = 0.619和p = 0.137)。

结论

年龄≥80岁的老年CRC患者与年轻患者具有相似的肿瘤学结局,年龄不是独立的预后因素。

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