Analysis on Prognosis Factors of Elderly Patients with Colon Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Xiaoxia , TANG Yuanxin

Department of Gastrointestinal Surgery，The Fourth Affiliated Hospital of China Medical University，Shenyang 110032，Liaoning Province, China;

Corresponding author：

Keywords：

Colon neoplasm; Elderly; Prognosis; Multivariate analysis

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ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P＜0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference （P＜0.05）. The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.

Citation： LI Xiaoxia,TANG Yuanxin. Analysis on Prognosis Factors of Elderly Patients with Colon Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(7): 732-736. doi: Copy

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24.	吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [J]. 中国普外基础与临床杂志, 2007, 14(6): 713715.
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1. Paraf F, Jothy S. Colorectal cancer before the age of 40: a casecontrol study [J]. Dis Colon Rectum, 2000, 43(9）: 12221226.
2. Mitry E, Benhamiche AM, Jouve JL, et al. Colorectal adenocarcinoma in patients under 45 years of age: comparison with older patients in a welldefined French population [J]. Dis Colon Rectum, 2001, 44(3): 380387.
3. Alici S, Aykan NF, Sakar B, et al. Colorectal cancer in young patients: characteristics and outcome [J]. Tohoku J Exp Med， 2003， 199(2): 8593.
4. Chan KK, Dassanayake B, Deen R, et al. Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and longterm: analysis of survival and prognostic markers [J]. World J Surg Oncol， 2010， 8: 8292.
5. 韦达, 许发培. 青年和高龄大肠癌的比较性研究 [J]. 肿瘤防治杂志, 2005, 12（24): 18781880.
6. 蔡善荣, 郑树, 张苏展. 不同年龄组大肠癌预后多因素分析的比较 [J]. 中华肿瘤杂志, 2005, 27（8）： 483485.
7. 高强, 窦倩慧, 方超, 等. 影响结肠癌患者术后并发症的多因素分析 [J]. 中国普外基础与临床杂志， 2011, 18（2）: 159163.
8. 卢震海, 万德森, 王国强, 等. 1126例结肠癌患者的临床病理特征及预后分析 [J]. 广东医学杂志, 2007, 28（6）: 908910.
9. Compton C, FenoglioPreiser CM, Pettigrew N, et al. American Joint Committee on Cancer Prognostic Factors Consensus Conference: Colorectal Working Group [J]. Cancer, 2000， 88(7): 17391757.
10. Ratto C, Sofo L, Ippoliti M, et al. Prognostic factor in colorectal cancer.Literature review for clinical application [J]. Dis Colon Rectum, 1998, 41（8）: 10331049.
11. Korenaga D, Ueo H, Mochida K, et al. Prognostic factors in Japanese patients with colorectal cancer: the significance of large bowel obstructionunivariate and multivariate analyses [J]. J Surg Oncol, 1991, 47(3): 188192.
12. Park YJ, Park KJ, Park JG, et al. Prognostic factors in 2230 Korean colorectal cancer patients: analysis of consecutively operated cases [J]. World J Surg， 1999， 23(7): 721726.
13. 汪建平, 杨祖立, 王磊, 等. 结直肠癌临床病理特征与预后的多因素回归分析 [J]. 中华肿瘤杂志， 2003, 25（1）: 5961.
14. Derwinger K, Gustavsson B. A study of lymph node ratio in stage IV colorectal cancer [J]. World J Surg Oncol, 2008, 6: 127132.
15. Derwinger K, Carlsson G, Gustavsson B, et al. A study of lymph node ratio as a prognostic marker in colon cancer [J]. Eur J Surg Oncol， 2008， 34(7): 771775.
16. Chin CC, Wang JY, Yeh CY, et al. Metastatic lymph node ratio is a more precise predictor of prognosis than number of lymph node metastases in stage Ⅲ colon cancer [J]. Int J Colorectal Dis， 2009， 24(11): 12971302.
17. Chua TC, Yan TD, Ng KM, et al. Significance of lymph node metastasis in patients with colorectal cancer peritoneal carcinomatosis [J]. World J Surg, 2009, 33（7): 14881494.
18. Sadahiro S, Suzuki T, Maeda Y, et al. Prognostic factors in patients with synchronous peritoneal carcinomatosis (PC) caused by a primary cancer of the colon [J]. J Gastrointest Surg, 2009, 13(9): 15931598.
19. Pestieau SR, Sugarbaker PH. Treatment of primary colon cancer with peritoneal carcinomatosis: comparison of concomitant vs. delayed management [J]. Dis Colon Rectum, 2000， 43(10): 13411346.
20. Merkel S, Wein A, Gunther K, et al. Highrisk group of patients with stage Ⅱ colon carcinoma [J]. Cancer, 2001, 92（6）: 14351443.
21. Gryfe R, Kim H, Hsieh ET, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer [J]. N Engl J Med, 2000, 342（2）: 6977.
22. Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatelliteinstability status as a predictor of benefit from fluorouracilbased adjuvant chemotherapy for colon cancer [J]. N Engl J Med, 2003, 349(3): 247257.
23. Elsaleh H, Iacopetta B. Microsatellite instability is a predictive marker for survival benefit from adjuvant chemotherapy in a populationbased series of stage Ⅲ colorectal carcinoma [J]. Clin Colorectal Cancer, 2001， 1(2): 104109.
24. 吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [J]. 中国普外基础与临床杂志, 2007, 14(6): 713715.
25. 汪晓东, 冯硕, 游小林, 等. 结直肠肿瘤多学科协作诊治模式下的随访体系建设 [J]. 中国普外基础与临床杂志, 2007, 14(6): 709712.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis on Prognosis Factors of Elderly Patients with Colon Cancer

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