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首页> 外文期刊>Journal of geriatric oncology >Colon cancer treatment and adherence to national guidelines: Does age still matter?
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Colon cancer treatment and adherence to national guidelines: Does age still matter?

机译：结肠癌治疗和遵守国家准则：年龄仍然重要吗？

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Introduction: In the past decades, much attention has been given to the risks of undertreatment of cancer in older patients. We set out to determine whether current treatment of colon cancer in older patients still differs from younger patients and to identify risk factors and physician's reasons for deviation from Dutch treatment guidelines. Patients and methods: Retrospective cohort study of all consecutive patients newly diagnosed with colon cancer at the Slotervaart Hospital in Amsterdam from January 2002 to December 2007. Data were collected using clinical charts. Results: Of 286 patients, 183 were 70. years or older. Ninety-one percent of older patients received curative surgery and 32% received adjuvant chemotherapy in accordance with guidelines compared to 100% and 85% in the younger group (p = 0.002 and p < 0.001 respectively). The primary reasons stated by the treating physician for withholding surgery were comorbidity and poor general health. For adjuvant chemotherapy, the main reason stated was age. For both surgery and chemotherapy, multivariate analysis revealed that deviation from guidelines was most strongly associated with age (surgery OR 1.18 (CI 1.06-1.30); p = 0.002 and chemotherapy OR 1.19 (CI 1.08-1.31); p < 0.001 respectively). Despite this selection, older patients experienced more postoperative morbidity and mortality than younger patients. Chemotherapy toxicity was equal in both groups, despite less aggressive regimens for older patients. Conclusion: At our centre, guideline adherence for surgery in older patients was high, and deviations were well motivated. Age still seems to be the most important factor for withholding chemotherapy, despite evidence suggesting benefit in selected older patients.
机译：简介：在过去的几十年中，对老年患者癌症治疗不足的风险给予了很多关注。我们着手确定老年患者当前的结肠癌治疗是否仍与年轻患者不同，并确定危险因素和医师偏离荷兰治疗指南的原因。患者和方法：2002年1月至2007年12月在阿姆斯特丹的Slotervaart医院对所有新近诊断出患有结肠癌的连续患者进行回顾性队列研究。使用临床图表收集数据。结果：286名患者中，有183名70岁或以上。符合指南的老年患者中有91％接受了根治性手术，32％接受了辅助化疗，而年轻组中分别为100％和85％（分别为p = 0.002和p​​ <0.001）。主治医生表示扣留手术的主要原因是合并症和总体健康状况不佳。进行辅助化疗的主要原因是年龄。对于手术和化疗，多变量分析显示，偏离指导原则与年龄最密切相关（手术OR 1.18（CI 1.06-1.30）; p = 0.002和化疗OR 1.19（CI 1.08-1.31）; p <0.001）。尽管选择了这种方法，但老年患者比年轻患者的术后发病率和死亡率更高。尽管对于老年患者而言，积极性较低的化疗方案在两组中均具有相同的化疗毒性。结论：在我们中心，对老年患者进行手术的指南依从性很高，并且有很好的动机引起偏差。尽管有证据表明年龄对某些老年患者有益，但年龄似乎仍然是拒绝化疗的最重要因素。

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