老年大肠癌生存分析

Survival analysis in elderly colorectal cancer patients

目的 分析老年大肠癌的预后影响因素。方法 回顾性分析经病理证实、临床和随访资料完整的70岁以上大肠癌 16 5例 ,应用Kaplan -Meier法计算生存率 ;使用COXRegression单因素和多因素回归模型分析多种临床和病理特征对生存期的影响。结果 总体 1、2、3、4、5年生存率分别为 87 76 %、6 5 96 %、5 2 0 5 %、4 2 77%、4 0 5 1% ,平均生存时间 4 1 89± 2 33月 ,中位生存时间 37月。单因素分析显示 ,预后与年龄、淋巴结是否转移、治疗方式、疾病分期、大体类型、病理类型、病理分级相关 (P <0 0 5 )。多因素分析表明 ,预后与Duke’s分期、年龄、淋巴结是否转移、治疗措施相关 ,其中治疗措施是最重要的独立影响因素。结论 老年大肠癌患者的预后受多种因素影响。治疗时应综合考虑 ,选择最佳治疗方法 。

Objective To analyse the prognostic factors in 165 colorectal patients aged≥70.Methods One hundred and sixty-five elderly patients with colorectal cancer diagnosed by histology were entered into the retrospective study between 1994 and 2001.Patients were given optimal operation alone,chemotherapy after operation,or chemotherapy alone according to tumor stage,histology,physical strength,and comorbid problems.Survival rate was calculated by Kaplan-Meier method,and compared with meaningful variances by Log-rank method.Prognostic factors were analyzed by Cox regression.Results The,1,2,3,4,5 year survival rate(all-cause mortality)were 87.76%,65.96%,52.05%,42.77%,40.51%,respectively.The mean survival time was 41.89±2.33months(95%CI:37.33～46.45 months),and the median survival time was 37 months.Univariate analysis showed that factors such as age,nodal metastasis,treatment method,Duke's stage,gross findings,kind of histology,and degree of differentiation had influences on the survival rate.Multivariate analysis showed that factors such as treatment method,Duke's stage,kind of histology and degree of differentiation were independent prognostic factors.Conclusion This study suggests that the prognosis of elderly colorectal cancer patients is influenced by several factors.Most of elderly patients can endure surgery and/or chemotherapy,and have a long-time survival and good quality of life.