| 高龄结直肠癌肝转移患者手术切除的安全性和可行性 |
| 投稿时间：2016-09-30 修订日期：2016-10-21 点此下载全文 |
| 引用本文：尹燕强,季学闻,马利兵,赵晋明,张金辉.高龄结直肠癌肝转移患者手术切除的安全性和可行性[J].医学研究杂志,2017,46(6):136-139 |
| DOI：
10.11969/j.issn.1673-548X.2017.06.035 |
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| 中文摘要:目的 本研究比较不同年龄段结直肠癌肝转移患者手术切除后的总体生存率及无病生存率，对比分析高龄患者行手术切除的安全性及可行性。方法 回顾分析137例结直肠癌肝转移患者。根据年龄分为高龄组（≥ 75岁，17例）、老年组（≥ 65岁~<75岁，75例）和年轻组（<65岁，45例）。比较3组患者间的手术切除时长、输血量、术后住院时间及术后相关并发症。结果 肝转移癌患者30天、60天病死率均明显升高（高龄组：5.9%和5.9%；老年组：2.7%和4%；年轻组：0%和2.2%）与年龄无显著相关性。高龄组、老年组和年轻组的5年总体生存率（OS）均较高，分别为40%、32%和45%，其差异无统计学意义（P>0.05）。3组患者1、3、5年的无病生存率（DFS）没有明显差距。3组患者术后并发症及患者1、3、5年无病生存率（DFS）差异无统计学意义（P>0.05），且年龄无显著相关性。结论 研究显示高龄患者手术后并发症发生率及病死率与青年患者相比差异无统计学意义（P>0.05）。因而，年龄并不能作为结直肠癌肝转移患者手术切除的禁忌证，手术切除治疗仍是高龄肝转移患者的首选治疗方案。伴随严格的术前患者情况评估后，高龄患者结直肠癌肝转移进行手术切除具有一定的安全性及可行性。 |
| 中文关键词:结直肠癌肝转移 高龄 手术切除 安全性 可行性 |
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| Safety and Feasibility of Surgical Resection for Very Elderly Patients with Colorectal Cancer with Liver Metastases |
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| Abstract:Objective To analyse the overall and disease-free survival for patients with CRLM according to their chronological age and to analyse the safety and feasibility of surgery in elderly patients. Methods A retrospective analysis of 137 cases of colorectal cancer patients with liver metastases was performed.They were Divided according to age groups of very elderly (≥ 75 years old, 17 cases), elderly patients (≥ 65 years old to <75 years, 75 cases) and the younger group (<65 years old, 45 cases). Comparison of surgical resection time, blood transfusion, postoperative hospital stay and surgical and postoperative complications among three groups was carried out. Results The very elderly group showed a non-significant increase in post-operative morbidity. The 30-day and 60-day/inpatient mortality rates increased with age without any significant statistically difference between the three groups (very elderly group 5.9% and 5.9%; elderly group:2.7% and 4%; and younger group 0% and 2.2%). At 5 years, the overall survival was 40% for very elderly patients (≥ 75 years old), 32% for elderly patients (≥ 65 years old to <75 years old) and 45% for younger patients (<65 years old). The 1-, 3-and 5-year disease-free survival was similar across the groups. Conclusion Liver resection for CRLM in carefully selected patients above the age of 75 can be performed with acceptable morbidity and mortality rates, similar to those in younger patients. Thus,we can conclude that advanced chronological age cannot be considered a contraindication to hepatic resection for CRLM,elderly patients should still be the preferred surgical excision.Elderly patients resection surgery is safe and feasible after rigorous preoperative evaluation. |
| keywords:Colorectal liver metastases(CRLM) Age Resection Safety and feasibility |
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