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摘要


Purpose. In Taiwan, there is an increasing trend in curative treatment for elderly patients with colorectal cancer. Since operation is the main treatment strategy for colorectal cancer, we analyzed the clinical information about the patients aged 80 years or older who had undergone operations for colorectal cancer to evaluate the risk factors of post-operative mortality. Materials and Methods. All study participants, aged more than 80 years, were recruited from patients who had received major operations for colorectal cancer at Linkou Chang Gung Memorial Hospital between March 1996 and September 2009. The operation type was tumor resection either by colectomy or proctectomy. Clinical data, including comorbidity, preoperative laboratory data, and cancer information, were collected to identify the significant risk factors associated with the post-operative mortality. Results. Atotal of 929 patients were enrolled during the study period. The average age was 83.5 (±3.5) years old. The post-operative mortality rate was 4.1%. Our result showed comorbidity with liver cirrhosis and pulmonary diseases, body mass index, pre-operative albumin level, laboratory examination for liver and renal function, emergent operation and metastatic status were significantly correlated with post-operative mortality. Conclusions. Since the increasing proportion of patients older than 80- year-old receiving operations for colorectal cancer, evaluation of the patients' pre-operative clinical conditions is important to minimize the risk of post-operative mortality. This study showed that several risk factors, including comorbidity with liver cirrhosis and pulmonary diseases, pre-operative poor nutrition status, impaired renal function and liver function, emergent operation and metastatic status, should be put into consideration before operation for those patients with CRC aged over 80-year-old.

並列摘要


目的 在台灣,愈來愈多罹患大腸直腸癌的老年人接受大腸直腸切除的治療。在以手術為主的治療方針之下,我們針對八十歲以上並接受大腸直腸癌切除的病人,分析手術後死亡的危險因子。方法 我們統計了從1996 年3 月到2009 年9 月共929 位八十歲以上老年人在林口長庚紀念醫院接受腫瘤切除與大腸或直腸切除手術治療的大腸直腸癌患的資料,並分析包含共病、術前實驗室檢驗、癌症相關資料與術後死亡的關係。結果 929 位病人的平均年齡為83.5 (±3.5) 歲且平均術後死亡率為4.1 百分比。我們的研究顯示病人本身肝硬化、肺部疾病、身體質量指數、術前白蛋白濃度、術前腎功能與肝功能的實驗室檢查、是否為緊急手術與是否有遠端轉移均為術後死亡的危險因子。結論 愈來愈多八十歲以上老年人接受大腸直腸癌症的手術。大腸直腸癌術後死亡的危險因子包括有肝硬化或肺部疾病病史、較差的營養狀況、較差的腎功能與肝功能、緊急手術與遠端轉移的患者。這些因素可以讓外科醫師做術前的評估以下降術後死亡的機率。

參考文獻


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