结节阳性结肠癌老年患者的结果:一个多中心基于人口的队列研究
Carl Pinter1, Shubham Sharma2, Aunum Abid1
1College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Clinical colorectal cancer
|December 20, 2024
概括
辅助化疗显著改善了III期结肠癌老年患者的生存率. 诸如过去的癌症病史和骨髓瘤的存在等因素预测结果较差,需要个性化治疗策略.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 流行病学 流行病学
背景情况:
- 在患有第三期结肠癌的老年患者 (≥70岁) 中,研究了生存的预后因素.
- 利用了来自萨斯喀彻温省 (2012-2018) 的大量基于人口的队列.
研究的目的:
- 确定临床,病理和上下文变量的预后意义.
- 评估辅助化疗对整体生存期 (OS) 和无病生存期 (DFS) 的影响.
主要方法:
- 对404名被诊断患有第三阶段结肠癌的老年患者进行了回顾性分析.
- 考克斯比例多变量生存分析,以确定OS和DFS的独立预测因素.
主要成果:
- 48%的患者≥80岁;66%患有并发症;46%患有高风险疾病.
- 辅助化疗改善了5年的DFS (49%vs. 30%) 和OS (64%vs. 49%) (P<.001).
- 较差的OS的独立预测因素包括过去的癌症史,骨头,高节点阳性与节点收获比率 (>0.1),高度瘤,表现不佳的状态,没有化疗,高风险疾病和升高的CEA.
结论:
- 辅助化疗为患有第三阶段结肠癌的老年患者提供了显著的生存益处.
- 过去的癌症史,瘤的存在,以及较高的节点阳性与节点收获的比率是更糟糕结果的关键预测因素.
- 个性化治疗方法对于改善这种患者群体的存活率至关重要.
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