高龄结直肠癌患者行根治性手术的安全性及预后分析

The safety and prognosis of radical surgery in old patients of colorectal cancer

目的探讨80岁以上高龄结直肠癌患者行根治性手术的安全性和可行性及结局。方法回顾性分析2010年1月至2020年12月中国医学科学院肿瘤医院372例结直肠癌患者的临床病理资料,包括术前临床特征、围手术期评估结果及术后病理结果。结果单因素分析结果显示,性别、年龄、BMI、术前HGB、生活习惯、手术方式、T分期、N分期、神经浸润、淋巴浸润及再次手术与肿瘤特异性生存率均有关(均P<0.20)。多因素COX回归分析结果显示,BMI>30 kg/m^(2)(HR:2.30,95%CI:1.27~4.17,P=0.006)和N1~N2期(HR:2.97;95%CI:1.48~5.97,P=0.002)是80岁以上高龄结直肠癌患者根治术后影响肿瘤特异性生存率的独立危险因素。结论80以上的高龄结直肠癌患者行根治性手术治疗是安全可行的,同时BMI和N分期是影响高龄结直肠癌患者术后预后的独立因素。

Objective To evaluate the safety and feasibility of radical surgery and explore prognostic factors affecting cancer-specific survival(CSS)in elderly patients with colorectal cancer(CRC).Methods From Jan 2010 to Dec 2020,a total of 372 elderly(aged over 80 years)CRC patients who underwent curative resection at the National Cancer Center were enrolled.Preoperative clinical features,perioperative outcomes and postoperative pathological characteristics were collected.Results In the multivariable COX regression analysis,BMI≥30 kg/m^(2)(HR:2.30,95%CI:1.27-4.17,P=0.006)and N1-N2 stage(HR:2.97,95%CI:1.48-5.97,P=0.002)correlated with worse CCS.Conclusions The results of this study demonstrated that radical resection for CRC is safe and feasible for patients over 80 years of age.BMI and N stage were independent prognostic factors for elderly CRC patients after radical resection.