Oxford University Hospitals NHS Foundation Trust, UK.
Ann R Coll Surg Engl. 2024 Sep;106(7):592-595. doi: 10.1308/rcsann.2023.0059. Epub 2024 Feb 26.
The aim of this study was to chart the natural history of elderly patients with colon cancer who are managed nonoperatively, with the primary outcome being life expectancy from diagnosis to death.
This was a retrospective analysis of patients aged 80 years and above diagnosed with colon cancer in a tertiary care referral hospital in England between 1 January 2012 and 31 December 2017.
Thirty-two patients were diagnosed with non-metastatic colon cancer and managed non-operatively. The median age of patients in this study was 86 years. The group had a median Charlson Comorbidity Index of 7 (range 6-12) and the median frailty score was 6 (range 3-8). Progression to metastatic disease was identified in two patients; two further patients showed locoregional progression of cancer and therefore required palliative surgical intervention. Survival of these patients ranged from 105 to 1,782 days with a median life expectancy of 586 days. Place of death was identified in 15/31 patients: 4 (27%) died in hospital, 12 (38%) died at home and 15 (47%) died in a nursing or residential home; data were missing for 1 patient (3%).
Nonoperative management of elderly patients with colon cancer yields reasonable life expectancy and a low risk of life-threatening local complications.
本研究旨在描述接受非手术治疗的老年结肠癌患者的自然病史，主要结局为从诊断到死亡的预期寿命。
这是对 2012 年 1 月 1 日至 2017 年 12 月 31 日期间在英国一家三级转诊医院诊断为结肠癌且年龄在 80 岁及以上的患者进行的回顾性分析。
32 名患者被诊断为非转移性结肠癌且接受非手术治疗。本研究中患者的中位年龄为 86 岁。该组的 Charlson 合并症指数中位数为 7（范围 6-12），脆弱性评分中位数为 6（范围 3-8）。两名患者进展为转移性疾病；另外两名患者出现癌症局部区域进展，因此需要姑息性手术干预。这些患者的生存时间从 105 天到 1782 天不等，中位预期寿命为 586 天。31 名患者中的 15 名患者的死亡地点得以确定：4 名（27%）死于医院，12 名（38%）死于家中，15 名（47%）死于疗养院或养老院；1 名患者（3%）的数据缺失。
对老年结肠癌患者进行非手术治疗可获得合理的预期寿命，并降低危及生命的局部并发症风险。
