Management and survival of colorectal cancer in the elderly in population-based studies
Management and survival of colorectal cancer in the elderly in population-based studies
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DOI：
10.1016/j.ejca.2007.08.008
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发表时间：
2007-10-01
影响因子：
8.4
通讯作者：
Bouvier, A. M.
中科院分区：
文献类型：
--
作者：
Faivre, J.;Lemmens, V. E. P. P.;Bouvier, A. M.
结直肠癌是老年患者的主要问题。大多数关于结直肠癌的治疗和存活率的数据都是由专科医院提供的，因此，由于不可避免的选择偏差，不能作为参考。癌症登记处记录了人口一级的治疗和生存数据，是评估患者管理的最佳宝贵资源。然而，由于常规收集此类数据的困难，文献中发表的报告很少。老年患者的相对存活率低于年轻患者。然而，年轻患者与老年患者之间的差距正在缩小。诊断阶段仍然是决定预后的主要因素。国家内部的存活率也有很大差异：东欧国家的存活率比西欧国家低得多。在老年人中尤其常见的共病增加了癌症治疗的复杂性，并影响了生存。在老年人结直肠癌的护理方面取得了很大的改善(为治愈而切除的患者比例增加了，手术死亡率降低了，诊断阶段有所改善)。手术不应仅以年龄为基础加以限制。可以做出进一步的改进，特别是在辅助治疗方面。(C)2007爱思唯尔有限公司。保留所有权利。
Colorectal cancer is a major problem in elderly patients. Most data on the management and survival of colorectal cancer has been provided by specialised hospital units and as such cannot be used as reference because of unavoidable selection bias. Cancer registries recording data on treatment and survival at a population level represent the best valuable resource to assess the management of patients. However, there is a paucity of reports published in the literature due to the difficulty to routinely collect such data. Relative survival rates in the elderly were lower than in younger patients. However, the gap that has separated younger from elderly patients is closing. Stage at diagnosis remains the major determinant of prognosis. There is also large variation in survival within countries: survival rates being dramatically lower in Eastern European countries, compared to Western European countries. Comorbidity, which is particularly frequent in the elderly, increases the complexity of cancer management and affects survival. Substantial improvement in the care of colorectal cancer in the elderly has been achieved (increase in the proportion of patients resected for cure, decrease in operative mortality, improvement in stage at diagnosis). Surgery should not be restricted on the basis of age alone. Further improvements can be made, in particular with respect to adjuvant therapy. (C) 2007 Elsevier Ltd. All rights reserved.