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[老年结直肠癌。我们的经验]

[Colorectal cancer in old age. Our experience].

作者信息

Uccheddu A, Cois A, Dessena M, Gromo C, Cagetti M

机构信息

Istituto di Chirurgia, Università degli Studi, Cagliari.

出版信息

Minerva Chir. 1994 Dec;49(12):1215-20.

PMID:7538207
Abstract

Two hundred and thirty-three patients treated for colorectal cancer during the period 1976-1991 were divided into three groups (A: < 65 yr; B: 65-74 yr; C: > 74 yr) in order to perceive possible statistically significant differences in patients older than 75 years. Epidemiological features are similar among the three groups, while a greater diagnostic delay (p = 0.013), a higher incidence of emergency procedures (p = 0.006) and a more advanced AP stage were found in group C. The high anesthesiological risk determined a conservative surgical approach only in 4.1% of patients, while a curative resection was performed on 51% of group C vs 72.7% of group A (p = 0.016). Postoperative complications and mortality for curative resections were 28% and 12% in group C vs 24.6% and 2.9% in group A (p = n.s.); the overall 5 years survival rate was 62.9%, 51.7% and 42.2% in groups A, B, and C. It is concluded that age alone should not be considered as a contraindication to curative surgery for colorectal cancer, for life expectancy and quality are considerably worse in the elderly undergoing derivative surgery.

摘要

1976年至1991年期间接受结直肠癌治疗的233例患者被分为三组(A组:年龄小于65岁;B组:65至74岁;C组:年龄大于74岁),以便了解75岁以上患者可能存在的统计学显著差异。三组的流行病学特征相似,但C组诊断延迟时间更长(p = 0.013),急诊手术发生率更高(p = 0.006),且AP分期更晚。高麻醉风险导致仅4.1%的患者采取保守手术方式,而C组51%的患者进行了根治性切除,A组为72.7%(p = 0.016)。C组根治性切除术后的并发症和死亡率分别为28%和12%,A组为24.6%和2.9%(p值无统计学意义);A、B、C三组的总体5年生存率分别为62.9%、51.7%和42.2%。结论是,不应仅将年龄视为结直肠癌根治性手术的禁忌证,因为接受姑息性手术的老年人的预期寿命和生活质量要差得多。

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