Shen Lei, Meng Ke, Wang Yifei, Yu Xiangli, Wang Ping, Zhang Xiaomei
Department of Gastroenterology, the First Medical Center of PLA General Hospital, Beijing, China.
Medical Big-data Research Center, Medical Innovation Research Division, PLA General Hospital, Beijing, China.
J Gastrointest Oncol. 2021 Feb;12(1):89-99. doi: 10.21037/jgo-21-63.
As the population ages, the number of elderly patients with colorectal cancer is increasing year by year. However, older people have rarely been the focus of studies on colorectal cancer. Therefore, in the present study, we aimed to carry out a retrospective analysis of this patient subgroup.
A retrospective study of clinical data of patients aged over 80 years who died from colorectal cancer in our hospital between 1993 and 2020 was performed. Logistic regression, the Kaplan-Meier method, and a multivariate Cox proportional hazards model were used to analyze the overall survival and treatment outcomes of the patients.
A total of 87 patients were included in the study. The overall median survival was 45 months. In most patients, the primary lesion was located in the right colon. One-quarter of the patients refused to accept any treatment. Patients with stage IV tumors, who accounted for the largest proportion of the study population, displayed a higher rate of abandoning treatment than did patients of other stages. Almost all patients with stages II and III accepted surgery. Patients who underwent surgery to treat their colorectal cancer had longer survival than those who did not.
Old age should not be a reason for giving up treatment for colorectal cancer. The treatment of colorectal cancer patients aged 80 years and above requires individualized evaluation and more aggressive treatment to achieve greater benefits.
随着人口老龄化,老年结直肠癌患者数量逐年增加。然而,老年人很少成为结直肠癌研究的重点。因此,在本研究中,我们旨在对这一患者亚组进行回顾性分析。
对1993年至2020年间在我院死于结直肠癌的80岁以上患者的临床资料进行回顾性研究。采用逻辑回归、Kaplan-Meier法和多变量Cox比例风险模型分析患者的总生存期和治疗结果。
本研究共纳入87例患者。总中位生存期为45个月。大多数患者的原发灶位于右半结肠。四分之一的患者拒绝接受任何治疗。IV期肿瘤患者占研究人群的比例最大,其放弃治疗的比例高于其他分期的患者。几乎所有II期和III期患者都接受了手术。接受结直肠癌手术治疗的患者生存期长于未接受手术的患者。
高龄不应成为放弃结直肠癌治疗的理由。80岁及以上结直肠癌患者的治疗需要个体化评估并采取更积极的治疗措施以获得更大益处。