80岁以上高龄结直肠癌患者的手术风险评估及生存分析  

Evaluation of operative risk and suvival of colorectal cancer patients 80 years of age and older

作　　者：廉朋[1] 顾卫列[1] 蔡三军[1] 莫善兢[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系复旦大学附属肿瘤医院大肠外科,上海200032

出　　处：《中华消化杂志》2010年第6期391-393,共3页Chinese Journal of Digestion

摘　　要：目的 评估80岁以上高龄结直肠癌患者的手术风险和疗效.方法 回顾性分析1987年12月至2005年6月99例高龄（80～91岁）结直肠癌患者的临床病理资料,分析患者的合并症、并发症、死亡率以及生存结果.对患者进行随访1～136个月,平均45.12个月.结果 99例患者中,合并症发生率为43.4%（43/99）,并发症为10.1%（10/99）,手术死亡率为0.80例患者完成随访,3年总生存率和无病生存率分别为64.3%和61.1%;5年总生存率和无病生存率分别为52.8%和52.1%.单因素生存分析显示手术的根治性、肿瘤组织分化程度、脉管内癌栓、分期和并发症是影响生存的预后因素.多因素生存分析证实只有手术的根治性才是影响预后的重要指标.结论 高龄结直肠癌患者具有高合并症风险,但是通过积极的干预和规范的手术操作,仍能获得良好的生存结果.Objective To estimate the operative risk and outcomes of colorectal cancer patients 80 years of age and older. Methods Colorectal cancer resection was performed in 99 patients 80 years of age and older between Dec. 1987 and June 2005. The informations about clinical data, co-morbidity,complications, operative mortality and survival were retrospectively analyzed. The patients were followed-up for 45.12 months （range 1-136） months. Results Of 99 patients, co-morbidity was found in 43 patients （43.4% ） and complication in 10 patients （10.1%）. No patient died of operation.Eighty patients completed the follow-up study. The overall 3-year survival rate and disease-free survival rate were 64.3% and 61.1%, respectively. Whereas the overall 5-year survival rate and disease-free survival rate were 52.8% and 52.1%, respectively. In univariate analysis, curative or palliative operation, tumor differentiation, cancer embolism in the vasculature, tumor staging and complications were proved to be significant prognostic factors. Multivariate survival analysis,however, showed that only the curative or palliative operation was independent factor for survival.Conclusions The high risk of co-morbidity for patients 80 years of age and older is not the obstacle to cancer resection.These patients will have satisfactory outcomes via optimal treatment and operation.

关 键 词：结直肠肿瘤 手术 预后 

分 类 号：R735.3[医药卫生—肿瘤]