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| Analysis of surgical value and survival in patients over 90 years of age with colorectal cancer |
| ZENG Weigen PANG Guoyi ZHAO Qi XIE Dehong QU Hao HAN Jiagang ZHAO Baocheng WANG Zhenjun▲ |
| Department of General Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China |
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Abstract Objective To analyze the surgical value and prognosis of patients with colorectal cancer aged over 90 years. Methods The clinical data of 94 patients over 90 years old with colorectal cancer admitted to Beijing Chao-yang Hospital, Capital Medical University from May 2003 to October 2019 were retrospectively analyzed, and they were divided into surgery group (72 cases) and non-surgery group (22 cases) according to whether they had undergone surgery or not. The clinical characteristics of the two groups were compared, and the influencing factors for the prognosis of patients were analyzed. Results The age, Eastern Cooperative Oncology Group (ECOG) physical status score, Charlson comorbidity index, and tumor stage in the non-surgery group were higher than those in the surgery group, and the differences were statistically significant (P ＜ 0.05). The difference of survival curve between the two groups was statistically significant (P ＜ 0.05). Univariate analysis showed that ECOG score ≥four points (HR = 2.024, 95%CI: 1.056-3.879, P = 0.034), the tumor stage at stage Ⅲ-Ⅳ (HR = 3.952, 95%CI: 2.201-7.097, P ＜ 0.001), Charlson comorbidity index ≥ ten (HR = 3.607, 95%CI: 2.079-6.258, P ＜ 0.001), no surgical treatment (HR = 4.465, 95%CI: 2.382-8.371, P ＜ 0.001) were correlated with prognosis. Multivariate analysis showed that the tumor stages at stage Ⅲ-Ⅳ (HR = 3.389, 95%CI: 1.830-6.279, P ＜ 0.001), Charlson comorbidity index ≥ten (HR = 2.570, 95%CI: 1.396-4.732, P = 0.002), and the absence of surgical treatment (HR = 2.190, 95%CI: 1.071-4.476, P = 0.032) were independent risk factors for poor prognosis. Conclusion Age ≥90 years old should not be a contraindication to surgery in patients with colorectal cancer, which can significantly prolong life.
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