Surgery for T4 Colorectal Cancer in Older Patients: Determinants of Outcomes

被引：35

作者：

Osseis, Michael ^{[1
]}

Nehmeh, William A. ^{[1
]}

Rassy, Nathalie ^{[1
]}

Derienne, Joseph ^{[1
]}

Noun, Roger ^{[1
]}

Salloum, Chady ^{[2
]}

Rassy, Elie ^{[3
]}

Boussios, Stergios ^{[4
,5
,6
]}

Azoulay, Daniel ^{[2
]}

机构：

[1] St Joseph Univ, Dept Gen Surg, Hotel Dieu France Hosp, Beirut 11072180, Lebanon

[2] Hop Paul Brousse, AP HP, Dept Hepatobiliary & Liver Transplantat Surg, F-75610 Villejuif, France

[3] Gustave Roussy, Dept Med Oncol, 114 Rue Edouard Vaillant, F-94800 Villejuif, France

[4] Medway NHS Fdn Trust, Dept Med Oncol, Windmill Rd, Gillingham ME7 5NY, England

[5] Kings Coll London, Fac Life Sci & Med, Sch Canc & Pharmaceut Sci, London SE1 9RT, England

[6] AELIA Org, 9th Km Thessaloniki Thermi, Thessaloniki 57001, Greece

来源：

JOURNAL OF PERSONALIZED MEDICINE | 2022年 / 12卷 / 09期

关键词：

postoperative complications; elderly; colorectal cancer; relative survival; T4; tumors; ELDERLY-PATIENTS; COLON-CANCER; RECOMMENDATIONS; RESECTION; INDEX; RISK;

D O I：

10.3390/jpm12091534

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: This study aimed to compare the outcomes of older and younger patients with T4 colorectal cancer (CRC) treated with surgery. Methods: Consecutive patients with T4 CRC treated surgically at Henri Mondor Hospital between 2008 and 2016 were retrospectively analyzed in age subgroups (1) 50-69 years and (2) >= 70 years for overall and relative survival. The multivariable analyses were adjusted for adjusted for age, margin status, lymph node involvement, CEA level, postoperative complications (POC), synchronous metastases, and type of surgery. Results: Of 106 patients with T4 CRC, 57 patients (53.8%) were 70 years or older. The baseline characteristics were generally balanced between the two age groups. Older patients underwent adjuvant therapy less commonly (42.9 vs. 57.1%; p = 0.006) and had a longer delay between surgery and chemotherapy (median 40 vs. 34 days; p < 0.001). A higher trend for POC was reported among the older patients but did not impact the survival outcomes. After adjusting for confounding factors, the overall survival was shorter among the older patients (HR = 3.322, 95% CI 1.49-7.39), but relative survival was not statistically correlated to the age group (HR = 0.873, 95% CI 0.383-1.992). Conclusions: Older patients with CRC were more prone to severe POC, but age did not impact the relative survival of patients with T4 colorectal cancer. Older patients should not be denied surgery based on age alone.

引用

页数：10