Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan.
Department of Surgery, Japanese Red Cross Maizuru Hospital, 427, Kuratani, Maizuru, 624-0906, Kyoto, Japan.
BMC Gastroenterol. 2024 Apr 2;24(1):125. doi: 10.1186/s12876-024-03213-y.
The occurrence of postoperative complications may affect short-term outcomes and prognosis of patients with various malignancies. However, the prognostic impact of these complications in older patients with colorectal cancer (CRC) remains unclear. Therefore, this study aimed to investigate the impact of severe postoperative complications on the oncological outcomes of older (aged ≥ 80 years) and non-older (aged < 80 years) patients with CRC.
We retrospectively analyzed 760 patients with stage I-III CRC who underwent curative surgery in two institutions between 2013 and 2019. The patients were categorized into older (aged ≥ 80 years, 191 patients) and non-older (aged < 80 years, 569 patients) groups. Short- and long-term outcomes were compared between the two groups.
The incidence of severe postoperative complications did not differ between the two groups (p = 0.981). Cancer-specific survival (CSS) was significantly worse in older patients with severe complications than in those without severe complications (p = 0.007); meanwhile, CSS did not differ between the non-older patients with severe complications and those without severe complications. Survival analysis revealed that the occurrence of severe postoperative complications was an independent prognostic factor for CSS in older patients (hazard ratio = 4.00, 95% confidence interval: 1.27-12.6, p = 0.017).
CRC surgery can be safely performed in older and non-older patients. Moreover, the occurrence of severe postoperative complications might more strongly affect the prognosis of older patients than that of non-older patients.
术后并发症的发生可能会影响各种恶性肿瘤患者的短期结局和预后。然而，这些并发症在老年结直肠癌（CRC）患者中的预后影响尚不清楚。因此，本研究旨在探讨严重术后并发症对老年（年龄≥80 岁）和非老年（年龄＜80 岁）CRC 患者的肿瘤学结局的影响。
我们回顾性分析了 2013 年至 2019 年在两个机构接受根治性手术的 760 例 I-III 期 CRC 患者。患者分为老年组（年龄≥80 岁，191 例）和非老年组（年龄＜80 岁，569 例）。比较两组的短期和长期结局。
两组严重术后并发症的发生率无差异（p=0.981）。严重并发症的老年患者的癌症特异性生存（CSS）明显差于无严重并发症的患者（p=0.007）；而严重并发症的非老年患者与无严重并发症的患者之间的 CSS 无差异。生存分析显示，严重术后并发症的发生是老年患者 CSS 的独立预后因素（危险比=4.00，95%置信区间：1.27-12.6，p=0.017）。
CRC 手术可安全地用于老年和非老年患者。此外，严重术后并发症的发生可能对老年患者的预后影响比对非老年患者的影响更大。
