Irvin T T
Department of Surgery, Royal Devon and Exeter Hospital, Wonford, UK.
Br J Surg. 1988 May;75(5):419-21. doi: 10.1002/bjs.1800750508.
The prognosis of colorectal cancer in the elderly was examined in a study of 306 consecutive patients. The patients were divided into two groups: Group 1 included 171 patients of average age 77 years (range 70-97); Group 2 comprised 135 patients of average age 59 years (range 22-69). There was no significant difference between the two groups with regard to the mode of presentation, the location and Duke's classification of the tumours, the incidence of palliative operations, and the perioperative mortality. The surgical mortality rates in Group 1 were 6 per cent overall, 4 per cent after elective operations, and 16 per cent after emergency surgery; the corresponding mortality rates for Group 2 were 3 per cent, 1 per cent, and 20 per cent. Emergency surgery was associated with a significantly higher incidence of perioperative death at any age (P less than 0.001) and most deaths resulted from complications of coexisting medical disorders or thrombo-embolic complications. Crude actuarial 5-year survival curves showed an increased death rate in Group 1 after 18 months and a significantly lower 5-year survival (P less than 0.05) but the age-corrected survival curves for the two groups were not significantly different, and it was concluded that the prognosis for colorectal cancer in the elderly is not significantly different from that of younger patients.
一项对306例连续患者的研究对老年结直肠癌患者的预后进行了检查。患者被分为两组：第一组包括171例平均年龄77岁（范围70 - 97岁）的患者；第二组由135例平均年龄59岁（范围22 - 69岁）的患者组成。两组在临床表现方式、肿瘤的位置和杜克分类、姑息手术的发生率以及围手术期死亡率方面没有显著差异。第一组的手术死亡率总体为6%，择期手术后为百分之4%，急诊手术后为16%；第二组相应的死亡率分别为3%、1%和20%。急诊手术在任何年龄都与围手术期死亡的显著更高发生率相关（P小于0.001），并且大多数死亡是由并存的内科疾病并发症或血栓栓塞并发症导致的。粗略的精算5年生存曲线显示第一组在18个月后死亡率增加且5年生存率显著更低（P小于0.05），但两组的年龄校正生存曲线没有显著差异，并且得出结论老年结直肠癌患者的预后与年轻患者没有显著差异。
