Surgical management and outcomes of obstructive colorectal cancer in elderly patients: A multi-institutional retrospective study

被引：2

作者：

Kondo, Akihiro ^{[1
,7
]}

Okano, Keiichi ^{[1
]}

Kumamoto, Kensuke ^{[1
]}

Kobara, Hideki ^{[2
]}

Nagahara, Teruya ^{[3
]}

Wato, Masaki ^{[4
]}

Shibatoge, Mitsushige ^{[5
]}

Minato, Takuya ^{[6
]}

Masaki, Tsutomu ^{[2
]}

Suzuki, Yasuyuki ^{[1
]}

机构：

[1] Kagawa Univ, Fac Med, Dept Gastroenterol Surg, Miki, Kagawa, Japan

[2] Kagawa Univ, Fac Med, Dept Gastroenterol & Neurol, Takamatsu, Kagawa, Japan

[3] Mitoyo Gen Hosp, Dept Gastroenterol, Kanonji, Kagawa, Japan

[4] Kagawa Prefectural Cent Hosp, Dept Gastroenterol, Takamatsu, Kagawa, Japan

[5] Takamatsu Red Cross Hosp, Dept Gastroenterol, Takamatsu, Kagawa, Japan

[6] Shikoku Med Ctr Children & Adults, Dept Surg, Zentsuji, Kagawa, Japan

[7] Kagawa Univ, Fac Med, Dept Gastroenterol Surg, 1750-1 Ikenobe, Miki, Kagawa 7610793, Japan

来源：

SURGERY | 2022年 / 172卷 / 01期

关键词：

LONG-TERM OUTCOMES; COLON-CANCER; SURGERY; RESECTION; PERFORATION; PROGNOSIS; MORTALITY; SURVIVAL; IMPACT; SAFETY;

D O I：

10.1016/j.surg.2021.12.007

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The outcomes and prognostic factors of elderly patients with obstructive colorectal cancer are unknown. This was the focus of our multi-institutional retrospective study. Methods: Medical records of 520 patients (elderly [group E, aged >75 years, n = 271]; and nonelderly [group NE, aged <75 years, n = 249]) who received treatment for obstructive colorectal cancer in 2008 to 2018 at 14 leading hospitals in Kagawa prefecture (Japan) were reviewed. Short-and long-term out-comes of patients who underwent tumor resection (n = 438) were compared between the groups. Their prognostic factors were identified. Results: The tumor resection rate was 79% (n = 213) and 90% (n = 225) in groups E and NE, respectively. Group E had more emergency resections (27 [12.7%] vs 15 [6.6%], P = .037), shorter operating times (194 vs 221 min, P < .001), fewer dissected lymph nodes (14 vs 17, P = .004), and less adjuvant chemotherapy (47 [26.8%] vs 122 [76.7%], p < .001) than group NE. Postoperative complication rates and recurrence-free survival were not significantly different between the groups. Overall survival was significantly lower in group E than in group NE. Distant metastases and no postoperative chemotherapy were independent poor prognostic factors for overall survival in groups E and NE. Emergency resection (hazard ratio:1.83; 95% confidence interval: 1.02-3.26) was a significant poor prognostic indicator in group E only. Conclusions: The short-term outcomes and recurrence-free survival of elderly and nonelderly patients with obstructive colorectal cancer were similar, although the 90-day mortality rate of the elderly patients was higher. Furthermore, elective surgery after bowel decompression is associated with a better outcome in the elderly. (c) 2021 Elsevier Inc. All rights reserved.

引用

页码：60 / 68

页数：9

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