University of British Columbia, Vancouver, British Columbia, Canada.
University of Calgary, Department of Medical Oncology, Tom Baker Cancer Centre, Canada.
J Geriatr Oncol. 2019 Jan;10(1):138-142. doi: 10.1016/j.jgo.2018.06.002. Epub 2018 Jun 28.
Life expectancy plays a key role in the selection of patients with stage III colon cancer for adjuvant chemotherapy, but little is known about causes of mortality in older patients with colon cancer. We aimed to examine causes of death in this population and compare these causes between patients who received chemotherapy and those who did not. Specifically, we chose to examine the rates of death related to recurrent colon cancer versus non colon cancer.
Patients aged 50 and older diagnosed with stage III colon cancer between 2005 and 2009 were included. Patients were divided into "younger" (aged 50-69) and "older" (aged 70+). Causes of death, which were categorized into colon cancer versus non-colon cancer related.
1361 patients were included, 50% of whom were 70 or older. Younger patients were more likely to receive adjuvant chemotherapy (90% vs. 60%). 601 patients died in the follow up period. Deceased patients in the younger group were more likely to die from colon cancer (81% vs. 62%). The most common cause of non-colon cancer death was other primary malignancies in younger patients and cardiovascular diseases in older patients. In older patients who received chemotherapy, 41% died; 89% of these deaths were related to colon cancer. In older patients who did not receive chemotherapy 72% died, with 38% of patients ultimately dying from colon cancer.
Older patients remain under-treated with chemotherapy. Although non-colon cancer deaths were more frequent in older patients with cancer, colon cancer was a still a significant cause of mortality. These deaths may be preventable with adjuvant chemotherapy.
预期寿命在选择 III 期结肠癌患者进行辅助化疗方面起着关键作用，但对于老年结肠癌患者的死亡原因知之甚少。我们旨在研究该人群的死亡原因，并比较接受化疗和未接受化疗的患者的死亡原因。具体来说，我们选择检查与复发性结肠癌相比，非结肠癌相关的死亡比率。
纳入 2005 年至 2009 年间诊断为 III 期结肠癌且年龄在 50 岁及以上的患者。将患者分为“年轻”（50-69 岁）和“年老”（70 岁及以上）。将死亡原因分为与结肠癌相关和与非结肠癌相关。
共纳入 1361 例患者，其中 50%的患者年龄在 70 岁或以上。年轻患者更有可能接受辅助化疗（90%比 60%）。在随访期间，有 601 例患者死亡。年轻组死亡患者更有可能死于结肠癌（81%比 62%）。非结肠癌死亡的最常见原因是年轻患者的其他原发性恶性肿瘤和老年患者的心血管疾病。在接受化疗的老年患者中，有 41%的患者死亡；这些死亡中有 89%与结肠癌有关。在未接受化疗的老年患者中，有 72%的患者死亡，其中 38%的患者最终死于结肠癌。
老年患者接受化疗的治疗仍不足。尽管患有癌症的老年患者中非结肠癌死亡更为常见，但结肠癌仍然是导致死亡的重要原因。辅助化疗可能可以预防这些死亡。
