八十岁的食道癌症:应该做食道切除术吗?
Lisa Cooper1, Ran Orgad2, Yochai Levi3
1Department of Geriatric Medicine, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel..
与年轻患者相比,八十岁以上 (≥80岁) 患者的食管切除术导致更严重的并发症和减少的存活率. 改善患者选择和准备对于老年食道癌症患者的更好的结果至关重要.
科学领域:
- 在瘤学瘤学.
- 老年人手术是一门老年人手术.
- 手术结果研究研究.
背景情况:
- 食道切除术是食道癌的标准治疗方法.
- 八十岁以上 (80岁及以上) 患者食道切除术结果的数据是相互矛盾的.
- 这项研究旨在比较80岁以上患者的术后结果和长期存活率与接受食道切除术的年轻患者.
研究的目的:
- 评估和比较经手术后的并发症和长期存活率在八十多岁的患者接受食道切除术的食道癌症.
- 为了确定与接受这种手术的老年患者不良结果相关的因素.
- 在老年人群中为食道癌进行手术治疗的临床决策提供信息.
主要方法:
- 一个前性维护的数据库的回顾性分析.
- 包括2012年至2021年间经过食道切除术的连续患有食道癌的患者.
- 患者被分为三个年龄组:<70,70-79岁和≥80岁.
主要成果:
- 八代人 (≥80) 的美国麻醉学会 (ASA) 评分较高,接受的新辅助疗法较少.
- 这一组经历的严重并发症显著增加,30天死亡率更高.
- 八十岁的人的总生存率显著降低 (年轻人群的平均生存时间为10个月,而年轻人群的平均生存时间为32个月和26个月).
- 多变量分析确定年龄≥80,癌症阶段和术后主要并发症作为减少生存的独立预测因素.
结论:
- 经过食道切除术的八分生殖器患者面临明显更高的重大术后并发症率和降低的长期生存率.
- 术后死亡率的增加可能导致这一年龄组的生存率较低.
- 加强患者选择和术前准备策略对于改善接受食道切除术的老年患者的治疗结果至关重要.
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