影响老年结直肠癌患者术后 1 年内死亡率的因素。

Factors contributing to the mortality of elderly patients with colorectal cancer within a year after surgery.

机构信息

Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Key Laboratory of Metabolism and Gastrointestinal Tumor, The First Affiliated Hospital of Shandong First Medical University, Key Laboratory of Laparoscopic Technology, The First Affiliated Hospital of Shandong First Medical University, Shandong Medicine and Health Key Laboratory of General Surgery, Jinan, Shandong, China.

Department of General Surgery, Shandong Provincial Qianfoshan Hospital, Weifang Medical College, Weifang, Shandong, China.

出版信息

J Cancer Res Ther. 2022 Apr;18(2):503-508. doi: 10.4103/jcrt.jcrt_1478_21.

DOI:10.4103/jcrt.jcrt_1478_21

PMID:35645121

Abstract

AIMS

Patients with colorectal cancer (CRC) have a lower survival rate during the first year following resection surgery. We analyzed the factors influencing this early mortality.

METHODS AND MATERIAL

The clinicopathological data of patients aged 70 years or older who underwent radical surgery for CRC between January 2012 and December 2018 were collected and analyzed retrospectively. A total of 242 patients (141 males and 101 females), including 93 with colon cancer and 139 with rectal cancer, were included in this study. Patients were divided into two groups according to whether they survived beyond the first year after surgery. The clinicopathological data of both groups were compared using Chi-square or Fisher's exact tests. The risk factors for mortality within 1-year after surgery were analyzed using the Cox regression model.

RESULTS

Forty-three patients experienced at least one complication, including 34 cases with Clavien-Dindo grade I-II complications and 12 with Clavien-Dindo grade III-IV complications. Eleven patients died in the year following surgery. Patients with postoperative complications had higher mortality rates within the first year. Univariate analysis revealed that carbohydrate antigen 19-9 (CA19-9) levels, American Society of Anesthesiologists (ASA) grades, and differentiation degree influenced the 1-year overall survival (OS) and disease-free survival (DFS). Multivariate analysis confirmed that CA19-9 levels and ASA grades were independent factors affecting OS and DFS during the first year after surgery.

CONCLUSION

Postoperative complications were associated with the early death of elderly CRC patients. CA19-9 levels and ASA grades are independent factors influencing OS and DFS.

摘要

目的

结直肠癌（CRC）患者在接受切除术治疗后的第一年的存活率较低。本研究分析了影响这种早期死亡率的因素。

方法和材料

回顾性收集 2012 年 1 月至 2018 年 12 月期间接受根治性 CRC 手术的年龄 70 岁或以上患者的临床病理资料。共纳入 242 例患者（男 141 例，女 101 例），其中结肠癌 93 例，直肠癌 139 例。根据术后是否存活超过 1 年将患者分为两组。采用卡方或 Fisher 确切检验比较两组的临床病理资料。采用 Cox 回归模型分析术后 1 年内死亡的危险因素。

结果

43 例患者发生至少一种并发症，包括 Clavien-Dindo 分级 I-II 并发症 34 例和 Clavien-Dindo 分级 III-IV 并发症 12 例。术后 1 年内 11 例患者死亡。术后并发症患者的 1 年死亡率更高。单因素分析显示，糖类抗原 19-9（CA19-9）水平、美国麻醉医师协会（ASA）分级和分化程度影响 1 年总生存率（OS）和无病生存率（DFS）。多因素分析证实，CA19-9 水平和 ASA 分级是影响术后 1 年 OS 和 DFS 的独立因素。