Colorectal Cancer Surgery in Extreme Elderly Population

• 作者: Alejandra Magdaleno Almudena Cotes Elena Asensio Guillermo Ricote Henry M. Ore Inmaculada Lozano Javier Gallego Plazas Jose M. Navarro Juan C. Navalon Maria C. Ors Maria J. Escudero Miguel A. Morcillo Montse Olcina
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: COLORECTAL CANCER SURGERY ELDERLY
• 年，卷（期）: azzlyw_2015,（1）
• 页码范围: 12-20
• 页数: 9页
• 分类号: R73

摘要

Background: Colorectal cancer surgery in extreme elderly population (380 years) is a growing problem and a subject in question. Experiences and results in this scenario are limited. Methods: Medical records of patients?380 years old hospitalized in General Surgery Department in Vega Baja Hospital between January 1st 2008 and December 31st 2012 were retrospectively reviewed. Patients diagnosed with colorectal cancer (CRC) were selected. Data regarding comorbidities, treatment performed, complications and survival were collected. Results: 95 patients (74 colon, 21 rectum) were identified: median age 83.0 years (80 - 93), 64.2% males. 93.7% of patients were operated on: median hospital and post-operative stay of 11 and 9 days, respectively;curative intention surgery 82.1%. 4.2% of patients were treated with interventionist procedures, and 2.1% of patients in a conservative way. 17.9% and 4.2% of patients came up with early and late complications, respectively. Early and late mortality occurred in 9.5% and 3.2% of patients, respectively. By March 2014, with a median follow up of 43.8 months, median overall survival for colorectal cancer patients was 2.7 years (95%IC, 2.0 - 3.2). Univariaye Cox Regresion analysis revealed the presence of cardiomyopathy (p = 0.024), the presence of chornic kidney disease (p = 0.025), the presence of comorbidities (vs absence) (0.026), the number of comorbidities (0.034), type of admission (p = 0.001), treatment with surgery (p = 0.001) and the incidence of early (p = 0.004) or late complications (p = 0.023) associated to overall survival with statically significance. Multivariate Cox Regression analysis showed number of comorbidities (HR = 1.104;95%CI: 0.851 - 1.431;p = 0.456), treatment with surgery (HR = 4.928;95%CI: 1.815 - 13.385;p = 0.002), programmed admission into hospital (HR = 2.316;95%CI: 1.298 - 4.133;p = 0.004), and the incidence of late complications (HR = 4.629;95%CI: 1.279 - 16.750;p = 0.020) independently associated with overall survival. Interaction test between number