Long-Term Survival in Octogenarians After Surgical Treatment for Colorectal Cancer: Prevention of Postoperative Complications is Key.
Long-Term Survival in Octogenarians After Surgical Treatment for Colorectal Cancer: Prevention of Postoperative Complications is Key.
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DOI：
10.1245/s10434-018-6766-1
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发表时间：
2018-12
影响因子：
3.7
通讯作者：
Faneyte IF
中科院分区：
文献类型：
--
作者：
Weerink LBM;Gant CM;van Leeuwen BL;de Bock GH;Kouwenhoven EA;Faneyte IF
是否以与年轻患者相同的方式治疗患有结直肠癌（CRC）的老年人仍然是一个具有挑战性的问题。本研究的目的是分析一组连续的接受CRC手术治疗的老年人的术后并发症和长期生存率。纳入了2008年1月至2011年12月期间适合根治性手术的原发性结直肠癌患者。从患者档案中回顾性收集关于合并症、肿瘤分期和并发症的数据。使用荷兰人和地址数据库检索关于生存的数据。为了确定与严重术后并发症和术后生存率相关的因素，进行了logistic回归分析和考克斯回归分析。估计比值比和风险比（HR）及95%置信区间（CI）。在一系列的108名老年人中，中位年龄为83岁（范围80-94岁）。中位随访时间为47个月（范围1-107）。25%的患者发生了严重的术后并发症。未发现发生严重术后并发症的风险因素。30天死亡率为7%; 1年和5年死亡率分别为19%和56%。总体中位生存期为48个月：无并发症患者为66个月，有术后并发症患者为13个月。术后并发症最能预测生存率下降（HR 3.16; 95% CI 1.79-5.59），甚至包括肿瘤特征、合并症和急诊手术。认为适合手术的老年人的长期生存率相当不错。预防术后主要并发症可进一步改善临床结局。
Whether to treat octogenarians with colorectal cancer (CRC) in the same manner as younger patients remains a challenging issue. The purpose of this study was to analyse postoperative complications and long-term survival in a consecutive cohort of octogenarians who were surgically treated for CRC. Octogenarians with primary CRC suitable for curative surgery between January 2008 and December 2011 were included. Data about comorbidities, tumour stage, and complications were retrospectively collected from patient files. Data about survival were retrieved with use of the Dutch database for persons and addresses. To identify factors associated with severe postoperative complications and postoperative survival, logistic regression analyses, and Cox regression analyses were performed. Odds ratios and hazard ratios (HR) with 95% confidence intervals (CI) were estimated. In a series of 108 octogenarians, median age was 83 years (range 80–94 years). Median follow-up was 47 (range 1–107) months. Major postoperative complications occurred in 25% of the patients. No risk factors for development of severe postoperative complications could be identified. The 30-day mortality was 7%; 1- and 5-year mortality was 19% and 56%, respectively. Overall median survival was 48 months: 66 months in patients without complications versus 13 months in patients with postoperative complications. Postoperative complications were most predictive of decreased survival (HR 3.16; 95% CI 1.79–5.59), even including tumour characteristics, comorbidity, and emergency surgery. Long-term survival in octogenarians deemed fit for surgery is reasonably good. Prevention of major postoperative complications could further improve clinical outcome.
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影响因子：
3.8
作者：
Latkauskas T;Rudinskaite G;Kurtinaitis J;Janciauskiene R;Tamelis A;Saladzinskas Z;Pavalkis D
通讯作者：
Pavalkis D
影响因子：
9
作者：
Chang, George J.;Skibber, John M.;Rodriguez-Bigas, Miguel
通讯作者：
Rodriguez-Bigas, Miguel
影响因子：
1.9
作者：
Bircan, Huseyin Yuce;Koc, Bora;Demirag, Alp
通讯作者：
Demirag, Alp
影响因子：
1.4
作者：
Kwiatt, Michael;Kawata, Michitaka
通讯作者：
Kawata, Michitaka
影响因子：
3
作者：
Millan, Monica;Merino, Sandra;Francesch, Tani
通讯作者：
Francesch, Tani