80岁以上结直肠癌65例的外科治疗

目的 探讨80岁以上老年患者结直肠癌的外科治疗策略. 方法 回顾性分析北京肿瘤医院1999-2006年外科手术治疗的80岁以上结直肠癌65例的临床资料.统计方法 采用单因素分析和Cox回归分析.结果 患者术后并发症发生率53.8%,术后吻合口漏发生率4%,手术死亡率1.5%.患者术后1年,3年,5年的生存率分别为79%,28%,16%.单因素分析和Cox回归分析结果 表明:肿瘤TNM分期和术前血色素降低及白细胞升高是影响患者预后的独立因素,而年龄,性别,肿瘤分化,术前CEA水平,血清蛋白水平,肿瘤大小不是影响患者预后的独立因素.结论 虽然80岁以上结直肠癌患者的手术风险较高,但经过完善的围手术期处理,可以获得较理想的治疗效果.

Surgical treatment strategy for elderly colorectal cancer patients

Objective To study the surgical treatment strategy for elderly(aged at 80 years or over)colorectal cancer patients.Methods There were 65 cases of colorectal cancer undergoing Surgical treatment in Beijing Cancer Hospital from 1999 to 2006,and results were analyzed retrospectively.Results In this group of patients.the postoperative morbidity was 53.8%,but anastomotic leakage rate was only 3.9%,operative mortality was 1.5%.Postoperative 1-,3-and 5-year survival rate was 78.92%,27.79%,and 16.32%respectively.Kaplan-meier analysis and Cox regression analysis showed that:the TNM stage of the tumor and preoperative hemoglobin and WBC level were independent prognostic factors,but patients' age,gender,preoperative serum level of CEA and albumin,tumor differentiation,tumor size were not independent prognosis factors.Conclusion Elderly CRC patients have a higher risk of surgical treatment.But with the improvement of perioperative management,the anastomotic fistula and mortality rate were not increased significantly and the result is satisfactory.