Surgical Treatment for Colorectal Cancer with Obstruction in Elderly Patients / 中国肿瘤临床

ABSTRACT

Objective: To evaluate the surgical procedures and prognostic factors for colorectal carcinoma in patients aged over 70. Methods: We retrospectively reviewed 31 colorectal cancer patients aged over 70 seen in our hospital between January 1992 and December 2001.Treatment procedures and outcome of these patients were analyzed.Kaplan-Meier method was used for survival analysis and Cox regression analysis was conducted to analyze prognostic factors. Results: The median age of these patients was 74 years.The median follow-up period was 12 months.The postoperative complication rate was 22.6%.The thirty-days mortality was 6.5%.There were 28 cases of tubular adenocarcinoma (well differentiated in 5 cases,moderately differentiated in 16 cases,and poorkly differentiated in 7 cases)and 3 cases of mucinous adenocarcinoma.As to Dukes stage,there were 8 cases of B stage,9 cases of C stge,and 14 cases of D stage.The overall 5-year survival rate was 22.7%.The 5-year survival rate was 44.4%in the radical surgery group and 7.7%in the palliative surgery group.The median survival period of all patients was 12 months.The median survival period was 38 months in the radical surgery group and 9 months in the palliative surgery group.Univariate analysis showed that the predictors for survival were age,co-morbidity,preoperative serum CEA level,preoperative serum albumin concentration,duration of surgery,radical surgery,and cancer stage. Conclusion: Radical resection is a prerequisite for cure of colorectal cancer with obstruction in elderly patients.Age and preoperative serum albumin concentration are independent prognostic indicators.