Hessman O, Bergkvist L, Ström S
Department of Surgery, Central Hospital of Västerås, Sweden.
Eur J Surg Oncol. 1997 Feb;23(1):13-9. doi: 10.1016/s0748-7983(97)80136-9.
Two hundred and two consecutive patients with colorectal cancer, aged 75 years or older, diagnosed between 1980 and 1990, were followed up from the date of diagnosis until their death or until October 1994. Of these, 194 underwent some type of surgery, in 151 cases elective and in 43 emergency. The peri-operative mortality rate was 10.8% and the overall 5-year survival rate 28%. The ASA score was a predictor for both peri-operative mortality and survival. Peri-operative mortality was significantly increased among patients who had palliative operations, and those with post-operative complications and blood transfusions. Overall survival was worse for patients with absence of blood in the stools or absence of anaemia, for patients who lived in institutions pre-operatively, and for patients with advanced tumour stages. We conclude that the survival rate in elderly patients with colorectal cancer is acceptable after surgery. Old age is not a risk factor per se for peri-operative mortality or poor prognosis, and should not disqualify a person from operation.
1980年至1990年间诊断的202例75岁及以上的连续性结直肠癌患者，从诊断之日起随访至死亡或1994年10月。其中，194例接受了某种类型的手术，151例为择期手术，43例为急诊手术。围手术期死亡率为10.8%，总体5年生存率为28%。美国麻醉医师协会（ASA）评分是围手术期死亡率和生存率的预测指标。接受姑息性手术的患者、有术后并发症和输血的患者围手术期死亡率显著增加。无便血或无贫血的患者、术前居住在机构中的患者以及肿瘤分期较晚的患者总体生存率较差。我们得出结论，老年结直肠癌患者术后生存率是可以接受的。高龄本身并非围手术期死亡率或预后不良的危险因素，不应成为患者手术的禁忌。
