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Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity

World Journal of Gastroenterology 2017年第8期23卷 1387-1396页

作者： hadar goldvaser Noa Katz Shroitman Irit Ben-Aharon Ofer Purim Yulia Kundel Daniel Shepshelovich Tzippy Shochat Aaron Sulkes Baruch Brenner Institute of Oncology Davidoff Cancer CenterBeilinson HospitalRabin Medical Center Sackler Faculty of Medicine Tel Aviv University Division of Medical Oncology and Hematology Princess Margaret Cancer Centre and the Department of MedicineUniversity of Toronto Department of Medicine A Beilinson HospitalRabin Medical Center Statistical Consulting Unit Beilinson HospitalRabin Medical Center

AIM To characterize colorectal cancer(CRC) in octogenarians as compared with younger *** A single-center, retrospective cohort study which included patients diagnosed with CRC at the age of 80 years or older between 2008-2013. A control group included consecutive patients younger than 80 years diagnosed with CRC during the same period. Clinicopathological characteristics, treatment and outcome were compared between the groups. Fisher's exact test was used for dichotomous variables and χ2 was used for variables with more than two categories. Overall survival was assessed by Kaplan-Meier survival analysis, with the log-rank test. Cancer specific survival(CSS) and disease-free survival were assessed by the Cox proportional hazards model, with the Fine and Gray correction for non-cancer death as a competing *** The study included 350 patients, 175 patients in each group. Median follow-up was 40.2 mo(range 1.8-97.5). Several significant differences were noted. Octogenarians had a higher proportion of Ashkenazi ethnicity(64.8% vs 47.9%, P < 0.001), a higher rate of personal history of other malignancies(22.4% vs 13.7%, P = 0.035) and lower rates of family history of any cancer(36.6% vs 64.6%, P < 0.001) and family history of CRC(14.4% vs 27.3%, P = 0.006). CRC diagnosis by screening was less frequent in octogenarians(5.7% vs 20%, P < 0.001) and presentation with performance status(PS) of 0-1 was less common in octogenarians(71% vs 93.9%, P < 0.001). Octogenarians were more likely to have tumors located in the right colon(45.7% vs 34.3%, P = 0.029) and had a lower prevalence of well differentiated histology(10.4% vs 19.3%, P = 0.025). They received less treatment and treatment was less aggressive, both in patients with metastatic and non-metastatic disease, regardless of PS. Their 5-year CSS was worse(63.4% vs 77.6%, P = 0.009), both for metastatic(21% vs 43%, P = 0.03) and for non-metastatic disease(76% vs 88%, P = 0.028).CONCLUSION Octogenarians pre

关键词：冒号直肠老八十至八十九岁年龄

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