How should patients 80 years of age or older with colorectal carcinoma be treated? - Long-term and short-term outcome and postoperative cytokine levels
How should patients 80 years of age or older with colorectal carcinoma be treated? - Long-term and short-term outcome and postoperative cytokine levels
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DOI：
10.1007/bf02236988
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发表时间：
2000-02-01
影响因子：
3.9
通讯作者：
Tadokoro, M
中科院分区：
文献类型：
--
作者：
Sunouchi, K;Namiki, K;Tadokoro, M
目得：本研究的目的是确定广泛切除术如何影响老年结直肠癌患者的手术发病率、死亡率和长期生存率。方法：收集1985 ~ 1997年我院收治的80岁以上大肠癌患者119例。排除了11名未接受手术的患者。其余108例患者接受了剖腹手术并进行了审查。对22例患者围手术期血清白细胞介素-G水平进行检测，以评估手术应激程度。研究结果：活动状态组72例患者中有64例（88.9%）进行了潜在根治性切除，而久坐状态组36例患者中有13例（36.1%）进行了潜在根治性切除（P < 0.001）。住院死亡率在活动状态组为8.3%，在久坐状态组为38%（P = 0.007）。久坐不动的表现状态组和接受急诊手术的患者比活动表现状态组或接受择期手术的患者的IL-G水平更高。结论：术前体能状态、手术可治愈性和肿瘤分期对80岁或以上结直肠癌患者的预后有显著影响。了解术后早期IL-6反应有助于预测该亚组患者的术后死亡率和发病率。
PURPOSE: The aim of this study was to determine how extensive resection affects operative morbidity, mortality, and long-term survival in elderly patients with colorectal cancer. METHODS: A total of 119 patients 80 years of age or older were given a diagnosis of colorectal carcinoma at our hospital between 1985 and 1997. Eleven patients who did not undergo surgery were excluded. The remaining 108 patients underwent laparotomy and were reviewed. Serum levels of interleukin-G were measured perioperatively in 22 patients to assess the degree of operative stress. RESULTS: Potentially curative resection was performed in 64 (88.9 percent) of the 72 patients in the active performance status group and 13 (36.1 percent) of the 36 patients in the sedentary performance status group (P < 0.001). The in-hospital mortality rate was 8.3 percent in group the active performance status group and 38 percent in the sedentary performance status group (P = 0.007). Patients in the sedentary performance status group and those who underwent emergency operations had higher levels of IL-G than patients in the active performance status group or those who underwent elective operations. CONCLUSIONS: Preoperative performance status, operative curability, and tumor stage have a significant impact on outcome in patients with colorectal cancer who are 80 years of age or older. Knowledge of early postoperative response of IL-6 is useful in predicting postoperative mortality and morbidity in this subgroup of patients.