Lee Soo Min, Shin Jun Sang
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Ann Coloproctol. 2020 Oct;36(5):323-329. doi: 10.3393/ac.2020.01.19.2. Epub 2020 Oct 31.
Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.
CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups: elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient's demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.
The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.
Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.
老年人群将占结直肠癌（CRC）患者的很大比例。我们根据80岁以上患者的临床和病理特征进行研究，以全面了解老年患者情况。
纳入2009年至2014年在我院确诊时年龄在60岁及以上的CRC患者。患者分为两组：老年组（年龄>80岁，n = 133）和对照组（年龄60至79岁，n = 596）。比较患者的人口统计学特征、CRC预后危险因素、临床病理参数、治疗情况和生存率。
平均年龄分别为83.9岁和64.8岁。两组的男女比例和肿瘤部位相当。单因素分析中发现的预后因素；分化程度、分期、淋巴管侵犯和癌胚抗原无统计学差异。微卫星不稳定性状态和回收淋巴结数量也相似（17.2对21.6，P = 0.505）。在化疗治疗方法上存在显著差异，因为III期和IV期老年患者往往省略辅助化疗（43.6%对92.8%，P < 0.001）或姑息化疗（35.8%对89.4%，P = 0.016）。除I期外，老年患者的总生存率显著较低。
当前研究表明，高龄CRC患者接受标准治疗的可能性较小，这可能导致较差的预后。随着老年CRC患者数量的增加，我们的结果为进一步对老年CRC患者进行临床和分子研究提供了依据。
