Aggelakopoulou Chrysa, Perivoliotis Konstantinos, Stergiannis Pantelis, Intas George, Mouzakis George, Tepetes Konstantinos
Department of Surgery, University Hospital of Larissa, Larissa, Greece.
Department of Oncology, General Hospital "Agioi Anargyroi", Athens, Greece.
Cancer Diagn Progn. 2023 Jul 3;3(4):504-513. doi: 10.21873/cdp.10247. eCollection 2023 Jul-Aug.
BACKGROUND/AIM: Current evidence regarding the optimal management of older colorectal cancer patients, is conflicting. Functional deficits impact long-term survival prognosis, while frailty often results to optimal treatment postponement. Thus, the characteristics of this subgroup combined with treatment deviations further perplex optimal oncological management. The study aim was to compare survival and optimal surgery rates between older and younger colorectal cancer patients.
This study was designed as a prospective cohort. All adult (³18 years) colorectal cancer patients operated, during the 2016-2020 period, in the Department of Surgery, University Hospital of Larissa, were considered as eligible. The primary endpoint of the study was the difference in terms of the overall survival between older (>70 year) and younger (<70 years) colorectal cancer patients.
Overall, 166 patients (60 younger and 106 older) were enrolled. Although the older subgroup displayed a higher rate (p=0.007) of ASA II and ASA III patients, mean CCI scores were comparable (p=0.384). The two subgroups were similar in terms of performed operations (p=0.140). No delay in surgery was noted. Most operations were performed using an open approach (open: 57.8% vs. laparoscopic: 42.2%), under an elective status (elective: 91% vs. emergency: 1.8%). There was no difference in terms of overall complications rate (p=0.859). Overall survival was similar (p=0.227) between the older and younger subgroups (25.68 vs. 28.48 months).
Older operated patients did not differ from their younger counterparts with regard to their overall survival. Due to several study limitations, further trials are required to confirm these findings.
背景/目的：目前关于老年结直肠癌患者最佳管理的证据相互矛盾。功能缺陷会影响长期生存预后，而虚弱往往导致最佳治疗推迟。因此，该亚组的特征与治疗偏差进一步使最佳肿瘤管理变得复杂。本研究的目的是比较老年和年轻结直肠癌患者的生存率和最佳手术率。
本研究设计为前瞻性队列研究。2016年至2020年期间在拉里萨大学医院外科接受手术的所有成年（≥18岁）结直肠癌患者均被视为符合条件。本研究的主要终点是老年（>70岁）和年轻（<70岁）结直肠癌患者的总生存差异。
总体而言，共纳入166例患者（60例年轻患者和106例老年患者）。尽管老年亚组中ASA II级和ASA III级患者的比例较高（p = 0.007），但平均CCI评分相当（p = 0.384）。两个亚组在手术方式方面相似（p = 0.140）。未发现手术延迟。大多数手术采用开放手术方式（开放手术：57.8% 对腹腔镜手术：42.2%），处于择期状态（择期手术：91% 对急诊手术：1.8%）。总体并发症发生率无差异（p = 0.859）。老年和年轻亚组的总生存率相似（p = 0.227）（25.68个月对28.48个月）。
接受手术的老年患者与年轻患者在总生存率方面没有差异。由于本研究存在若干局限性，需要进一步试验来证实这些发现。
