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首页> 外文期刊>ANZ journal of surgery >Colorectal cancer in the elderly. Is there a role for safe and curative surgery?
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Colorectal cancer in the elderly. Is there a role for safe and curative surgery?

机译：老年人大肠癌。安全和治愈性手术有作用吗？

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BACKGROUND: Recent reports place colorectal cancer (CRC) as the third most common cancer for both sexes. Elderly patients are often viewed as high-risk surgical candidates with high rates of emergency presentations and perioperative mortality. The aim of our study was to examine the characteristics and perioperative morbidity and mortality rates of elderly patients presented to CRC surgery. METHODS: We retrospectively studied 248 patients who underwent surgery for CRC at our institution between July 2003 and December 2005. Risk factors included sex, age, cancer localization, Dukes' and TNM classification, blood transfusion, preoperative Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity score and mode of presentation. Primary outcome was perioperative death. RESULTS: The study consisted of 143 men and 105 women. One hundred and thirty-four (54%) patients were more than 75 years of age. In the two older groups, cancer was more common in the proximal colon than in theyoungest age group (P = 0.001). Of the 25 resections carried out as emergency, 20 were in those who were more than 75 years of age (P < 0.001). In elective procedure, perioperative mortality scores were 3.1% in those who were more than 75 years of age versus 0% in those less than 75 years, meanwhile in emergency, rates of 24 versus 0% (P = not significant) were registered. In Cox multivariate regression analysis, age and mode of presentation reached statistical significance. CONCLUSION: Old age itself is not an independent negative prognostic factor for CRC surgery. Although emergency operations were associated with poor outcome, most patients survived and left the hospital. This study suggests that, whenever possible, curative intent should be applied in patients with CRC, irrespective of the age.
机译：背景：最近的报道将大肠癌（CRC）列为男女第三大常见癌症。老年患者通常被视为高危手术对象，其急诊表现和围手术期死亡率很高。我们研究的目的是检查老年患者接受CRC手术的特征，围手术期发病率和死亡率。方法：我们回顾性研究了2003年7月至2005年12月间我院接受CRC手术的248例患者。危险因素包括性别，年龄，癌症定位，Dukes和TNM分类，输血，术前生理和手术严重程度评分死亡率和发病率得分和表现方式。主要结果是围手术期死亡。结果：该研究由143名男性和105名女性组成。一百三十四（54％）名患者年龄超过75岁。在两个年龄较大的组中，近端结肠癌比最年轻的组更常见（P = 0.001）。在紧急情况下进行的25例切除中，有75例年龄超过75岁（P <0.001）。在择期手术中，年龄大于75岁的患者围手术期死亡率评分为3.1％，而年龄小于75岁的患者围手术期死亡率评分为0％，同时在紧急情况下，发生率分别为24 vs. 0％（P =不显着）。在Cox多元回归分析中，年龄和表现方式达到统计学意义。结论：老年本身并不是CRC手术的独立阴性预后因素。尽管急诊手术与不良预后相关，但大多数患者仍然存活并离开了医院。这项研究表明，无论年龄大小，都应在CRC患者中尽可能采用治愈方法。

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