Lee Tae-Hoon, Choo Jeong Min, Kim Jeong Sub, Shin Seon Hui, Kim Ji-Seon, Baek Se-Jin, Kwak Jung-Myun, Kim Jin, Kim Seon-Hahn
Department of Surgery, Korea University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2022 Jun;38(3):244-252. doi: 10.3393/ac.2021.00619.0088. Epub 2021 Nov 4.
Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age.
A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared.
Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391).
CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.
结直肠癌（CRC）在所有年龄组中均有发生，治疗方法的应用可能因年龄而异。本研究旨在按年龄确定结直肠癌的特征。
回顾了2006年9月至2019年7月期间共4326例行结直肠癌初次切除术的患者。比较了患者和肿瘤特征、手术及术后数据以及肿瘤学结局。
60至69岁的患者年龄组最大（29.7%），其次是50至59岁和70至79岁的患者（分别为24.5%和23.9%）。直肠癌在所有年龄组中都很常见，但老年患者中右侧结肠癌往往更为常见。在高龄患者中，急诊手术数量显著，开放手术和永久性造口的频率更高。相比之下，十几岁和二十几岁的患者经常进行全腹结肠切除术或全直肠结肠切除术。老年患者的肿瘤分期更晚，术后肠梗阻更多。老年患者辅助治疗的发生率较低，随访时间也较短。0至3期结直肠癌的老年患者总生存期缩短（P<0.001），但无病生存期在各年龄组间无差异（P=0.391）。
在韩国，可能有必要比目前更早地进行结直肠癌筛查。此外，通过积极治疗越来越多的老年结直肠癌患者，可以改善手术和肿瘤学结局。
