Lim Byeo Lee, Park In Ja, Ro Jun-Soo, Kim Young Il, Lim Seok-Byung, Yu Chang Sik
Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Ann Coloproctol. 2025 Jun;41(3):198-206. doi: 10.3393/ac.2023.00367.0052. Epub 2024 Aug 5.
The aim of this study was to examine the prognosis and associated risk factors, including adjuvant chemotherapy (CTx), in elderly patients with colon cancer.
This retrospective study included patients who underwent radical resection for colon cancer between January 2010 and December 2014 at Asan Medical Center. The effects of stage, risk factors, and chemotherapy on overall survival (OS) and recurrence-free survival (RFS) were compared in patients aged ≥70 and <70 years.
Of 3,313 patients, 933 (28.1%) was aged ≥70 years. Of the 1,921 patients indicated for adjuvant CTx, 1,294 of 1,395 patients (92.8%) aged <70 years and 369 of 526 patients (70.2%) aged ≥70 years received adjuvant CTx. Old age (≥70 years) was independently associated with RFS in overall cohort. Among patients aged ≥70 years indicated for adjuvant CTx, the 5-year OS (81.6% vs. 50.4%, P<0.001) and RFS (82.9% vs. 67.4%, P=0.025) rates were significantly higher in those who did than did not receive adjuvant CTx. Additionally, adjuvant CTx was confirmed as independent risk factor of both OS and RFS in patients aged ≥70 years indicated for adjuvant CTx.
Old age was associated with poor RFS and adjuvant CTx had benefits in OS as well as RFS in elderly patients eligible for adjuvant CTx.
本研究旨在探讨老年结肠癌患者的预后及相关危险因素，包括辅助化疗（CTx）。
这项回顾性研究纳入了2010年1月至2014年12月在峨山医疗中心接受结肠癌根治性切除术的患者。比较了年龄≥70岁和＜70岁患者的分期、危险因素及化疗对总生存期（OS）和无复发生存期（RFS）的影响。
在3313例患者中，933例（28.1%）年龄≥70岁。在1921例有辅助CTx指征的患者中，年龄＜70岁的1395例患者中有1294例（92.8%）接受了辅助CTx，年龄≥70岁的526例患者中有369例（70.2%）接受了辅助CTx。在整个队列中，老年（≥70岁）与RFS独立相关。在年龄≥70岁且有辅助CTx指征的患者中，接受辅助CTx的患者5年OS率（81.6%对50.4%，P＜0.001）和RFS率（82.9%对67.4%，P = 0.025）显著高于未接受辅助CTx的患者。此外，辅助CTx被确认为年龄≥70岁且有辅助CTx指征患者的OS和RFS的独立危险因素。
老年与较差的RFS相关，辅助CTx对符合辅助CTx条件的老年患者的OS和RFS均有益处。
