Multiple colorectal cancers in the elderly: a retrospective study of both surgical and autopsy cases
Multiple colorectal cancers in the elderly: a retrospective study of both surgical and autopsy cases
复制标题
DOI：
10.1007/s005350170016
复制
发表时间：
2001-11-01
影响因子：
6.3
通讯作者：
Esaki, Y
中科院分区：
文献类型：
--
作者：
Arai, T;Sawabe, M;Esaki, Y
背景大肠多原发癌并不罕见。并且占结肠直肠癌（CRC）患者的大约5-7%。老年人多发性结直肠癌的临床病理特征报道较少。方法.我们对947例手术患者和362例尸检样本进行了临床病理学研究，这些样本来自65岁或以上的CRC患者，其中包括81例手术和34例尸检病例。我们比较了高龄组（年龄大于或等于85岁）与年轻组的数据，即，65-74岁为中老年组，75-84岁为中老年组。结果外科手术组和尸检组的多个CRC分别为8.6%（81/947）和9.4%（34/362）。三个年龄组之间无显著性差异。相似的部位分布和性别比，表明随着年龄的增长，近端移位和女性占主导地位，发现在多个和单一的CRC，除了尸检病例与多个CRC。手术组和尸检组中，非相邻节段多发CRC分别占11%（9/81）和35%（12/34）。在尸检病例中，单发结直肠癌患者的结直肠外恶性肿瘤发生率在中老年组为22%（17/76），中老年组为27%（39/147），高龄组为35%（37/105），而多发结直肠癌患者的结直肠外恶性肿瘤发生率分别为25%（1/4），11%（2/18），结直肠外器官恶性肿瘤以胃最多见（29%），其次为肺（14%）、造血系统（12%）和胰胆系统（10%）。结论.这些结果表明，在老年结直肠癌患者中，多个结直肠癌的发生率约为8%-10%，无年龄相关差异。而结直肠外恶性肿瘤随着年龄的增长而增加。
Background Multiple primary cancers are not rare events in the large intestine. and account for approximately 5-7% of patients with colorectal cancer (CRC). There are few reports demonstrating clinicopathologic features of multiple CRCs in the elderly. Methods. We clinicopathologically investigated 947 surgical patients and 362 autopsy samples from patients aged 65 years or more with CRC including 81 surgical and 34 autopsy cases of multiple CRCs. We compared the data in the very old group (age greater than or equal to 85 years) with those of the younger age groups, i.e., a young-old group (65-74 years) and a middle-old group (75-84 years). Results. The proportion of multiple CRCs was 8.6% (81/947) in the surgical patients and 9.4% (34/362) in the autopsy cases. with no significant difference among the three age groups. Similar site distributions and sex ratios, indicating proximal shift and female predominance with advancing age, were found in multiple and single CRCs, except for autopsy cases with multiple CRCs. Multiple CRCs in nonadjacent segments of the large intestine accounted for 11% (9/81) in surgical cases and 35% (12/34) in autopsy cases. In autopsy cases, the incidence of extracolorectal malignancies in patients with a single CRC was 22% (17/76) in the young-old group, 27% (39/147) in the middle-old group, and 35% (37/105) in the very old group, whereas the incidences in patients with multiple CRCs were 25% (1/4), 11% (2/18), and 50% (6/12), respectively, Regarding the organs with extracolorectal malignancies, the stomach (29%) was most frequent, followed by lung (14%), hematopoietic system (12%), and pancreatobiliary system (10%). Conclusions. These results indicate that the incidence of multiple CRCs in elderly patients with CRC is approximately 8%-10%, with no age-related difference. while extracolorectal malignancies increase with advancing age.