Edna T H, Bjerkeset T
Department of Surgery, Innherred Hospital, Levanger, Norway.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2142-5.
BACKGROUND/AIMS: The aim of the study was to compare the short- and long-term outcome of older and younger patients treated for colorectal cancer. We also wanted to study whether age was independently associated with post-operative mortality.
We conducted a retrospective study of 503 consecutive patients treated for colorectal cancer. One hundred and six (21%) were 80 years of age or older. The median follow-up was 5.5 years (2-16.8 years) or until death.
Post-operative mortality was 6% (0.7% in patients less than 65 years and 16% in patients over 80 years). Multiple logistic regression analysis showed that age, emergency operation, advanced T-stage, and ASA-class were each independently related to post-operative mortality. The overall estimated 5-year survival rate was 59% in patients less than 65 years and 24% in patients over 80 years. The cancer specific 5-year survival was 62% in patients less than 65 years and 45% in patients over 80 years.
The study demonstrated that age was an independent risk factor for post-operative mortality. In very old patients surviving the post-operative period, the long-term outcome was good. Advanced age alone should not be used as a criterion to deny surgery for colorectal cancer.
背景/目的：本研究旨在比较接受结直肠癌治疗的老年和年轻患者的短期和长期预后。我们还想研究年龄是否与术后死亡率独立相关。
我们对503例连续接受结直肠癌治疗的患者进行了一项回顾性研究。其中106例（21%）年龄在80岁及以上。中位随访时间为5.5年（2 - 16.8年）或直至死亡。
术后死亡率为6%（65岁以下患者为0.7%，80岁以上患者为16%）。多因素逻辑回归分析显示，年龄、急诊手术、T分期进展和美国麻醉医师协会（ASA）分级均与术后死亡率独立相关。65岁以下患者的总体估计5年生存率为59%，80岁以上患者为24%。癌症特异性5年生存率在65岁以下患者中为62%，在80岁以上患者中为45%。
该研究表明年龄是术后死亡率的独立危险因素。对于术后存活的高龄患者，长期预后良好。不应仅以高龄作为拒绝结直肠癌手术的标准。
