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80岁以上的患者应该接受结直肠癌或胃癌手术吗?

Should patients over 80 years old be operated on for colorectal or gastric cancer?

作者信息

Houry S, Amenabar J, Rezvani A, Huguier M

机构信息

Department of Digestive Surgery, Hopital Universitaire Tenon, Paris.

出版信息

Hepatogastroenterology. 1994 Dec;41(6):521-5.

PMID:7536703
Abstract

One hundred and three patients aged 80 years or more were operated on for colorectal cancer (n = 80) or gastric cancer (n = 23). The postoperative mortality rate was 8%. Hospital mortality (12%) was not influenced by the factors age or emergency procedure, but by the factors ASA score (P = 0.06), palliative procedure (p = 0.08), and gastric surgery (P = 0.05). The overall 5-year survival rate was 23% after colorectal surgery, and 10% after gastric surgery (P = 0.001). After colorectal surgery, long-term survivals were observed, even in presence of serosal and/or lymph nodes involvement. Thirteen patients were alive more than five years after surgery. In contrast, after gastric surgery, all patients, except those with early carcinoma, died within one year. Indications for operation must be wide in colorectal cancers, and more restrictive in gastric cancers. Long-term survivals were observed after colorectal surgery in the elderly, even in the presence of lymph node involvement. In contrast, after gastric surgery, all patients, except those with early carcinoma, died within one year.

摘要

103名80岁及以上的患者接受了结直肠癌(n = 80)或胃癌(n = 23)手术。术后死亡率为8%。医院死亡率(12%)不受年龄或急诊手术因素的影响,而是受美国麻醉医师协会(ASA)评分(P = 0.06)、姑息手术(P = 0.08)和胃手术(P = 0.05)因素的影响。结直肠手术后的总体5年生存率为23%,胃手术后为10%(P = 0.001)。结直肠手术后,即使存在浆膜和/或淋巴结受累,也观察到长期生存情况。13名患者术后存活超过5年。相比之下,胃手术后,除早期癌患者外,所有患者均在1年内死亡。结直肠癌的手术指征必须放宽,而胃癌的手术指征应更严格。在老年人中,结直肠手术后观察到长期生存情况,即使存在淋巴结受累。相比之下,胃手术后,除早期癌患者外,所有患者均在1年内死亡。

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