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【Cancer research】胃食管癌患者年龄对生存时间影响

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dr_duran

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Association of Age and Survival in Patients With Gastroesophageal Cancer Undergoing Surgery With or Without Preoperative Therapy
有或无术前治疗的胃食管癌患者年龄对生存时间的影响
ABSTRACT
Background: Meticulous selection of patients for esophageal cancer surgery is critical, because major surgical intervention can cause considerable consequences. For this study, the authors explored their institution's large surgical experience to examine the impact of age on long-term patient survival and surgical complications.

Method: Six hundred consecutive patients with esophageal cancer who underwent surgery (409 patients received preoperative therapy, and 191 patients underwent surgery first) were analyzed. All demographic information (including American Society of Anesthesiology risk scores) and therapy-related information was collected retrospectively. Multiple statistical methods were used to assess survival rates and surgical complications and their correlation with patient age. Twenty-one patients (30-day mortality) first were excluded (n = 600) and then were included (n = 621) in the analysis.

Results: By using the median age ( ≤ 60 years) as the cutoff point and creating 2 subgroups (ages 61 years to 70 years and aged >70 years) in patients older than the median age, univariate analysis demonstrated a higher risk of death with increasing age (P = .019). In multivariate analysis, increasing age was an independent prognosticator of poor overall survival (P = .041). The inclusion of 30-day mortality did not alter the results. Surgical complications were statistically significantly higher in older patients compared with younger patients in the following categories: aspiration pneumonia, adult respiratory distress syndrome, cardiovascular, neurologic, and miscellaneous complications.

Conclusions: The data in this study demonstrated that patients aged ≤ 60 years who underwent surgery for esophageal cancer achieved the best overall survival and experienced fewer surgical complications than patients aged >70 years. Age was identified as an important variable in the selection of patients for esophageal cancer surgery.

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2009-10-23 21:52 浏览 : 550 回复 : 1

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dr_duran

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Association of Age and Survival in Patients With Gastroesophageal Cancer Undergoing Surgery With or Without Preoperative Therapy
有或无术前治疗的胃食管癌患者其年龄对生存时间的影响

ABSTRACT
摘要

Background: Meticulous selection of patients for esophageal cancer surgery is critical, because major surgical intervention can cause considerable consequences. For this study, the authors explored their institution's large surgical experience to examine the impact of age on long-term patient survival and surgical complications.
背景：精确挑选适合手术治疗的食管癌患者是关键，因为外科手术是影响患者疾病结局的主要因素。据了解，研究者通过评估外科手术以检测年龄因素对患者长期生存时间和手术并发症的影响

Method: Six hundred consecutive patients with esophageal cancer who underwent surgery (409 patients received preoperative therapy, and 191 patients underwent surgery first) were analyzed. All demographic information (including American Society of Anesthesiology risk scores) and therapy-related information was collected retrospectively. Multiple statistical methods were used to assess survival rates and surgical complications and their correlation with patient age. Twenty-one patients (30-day mortality) first were excluded (n = 600) and then were included (n = 621) in the analysis.
方法：分析了连续入组的600例接受了外科手术的食管癌患者（409名接受了术前治疗，191名则直接接受了手术）。所有有效信息（包括美国麻醉学会的风险评分）和治疗相关信息都采用回顾性方式收集。采用多种统计学方法评估生存率和手术并发症以及与患者年龄的关系。21名患者(30天死亡率)首先被排除（n=600），然后进行分析（n=621）。

Results: By using the median age ( ≤ 60 years) as the cutoff point and creating 2 subgroups (ages 61 years to 70 years and aged >70 years) in patients older than the median age, univariate analysis demonstrated a higher risk of death with increasing age (P = .019). In multivariate analysis, increasing age was an independent prognosticator of poor overall survival (P = .041). The inclusion of 30-day mortality did not alter the results. Surgical complications were statistically significantly higher in older patients compared with younger patients in the following categories: aspiration pneumonia, adult respiratory distress syndrome, cardiovascular, neurologic, and miscellaneous complications.
结果：用中位年龄为分界点（≤ 60岁），将研究对象分为2个亚组，即小于等于60岁和大于等于61岁两组，单变量分析显示随着年龄的增加，死亡风险增加（P = .019）。而多因素分析显示，年龄增加作为食管癌患者的独立预后因素（P = .041）。包括30天死亡率对研究结果没有影响。与年轻患者相比，年龄越大，其外科并发症明显增加，体现在以下几个方面：吸入性肺炎，成人呼吸窘迫综合症，心血管，神经系统以及多系统并发症。

Conclusions: The data in this study demonstrated that patients aged ≤ 60 years who underwent surgery for esophageal cancer achieved the best overall survival and experienced fewer surgical complications than patients aged >70 years. Age was identified as an important variable in the selection of patients for esophageal cancer surgery.
结论：该研究显示，与年龄大于70岁的患者相比，年龄低于60岁（包括60岁）且接受了外科手术的食管癌患者有较好的总生存时间及较少的手术并发症。提示年龄在患者是否接受食管癌手术时作为重要的参考指标。
----------------------------------------------------------
编译

有或无术前治疗的胃食管癌患者其年龄对生存时间的影响

摘要

背景：精确挑选适合手术治疗的食管癌患者是关键，因为外科手术是影响患者疾病结局的主要因素。据了解，研究者通过评估外科手术以检测年龄因素对患者长期生存时间和手术并发症的影响

方法：分析了连续入组的600例接受了外科手术的食管癌患者（409名接受了术前治疗，191名则直接接受了手术）。所有有效信息（包括美国麻醉学会的风险评分）和治疗相关信息都采用回顾性方式收集。采用多种统计学方法评估生存率和手术并发症以及与患者年龄的关系。21名患者(30天死亡率)首先被排除（n=600），然后进行分析（n=621）。

结果：用中位年龄为分界点（≤ 60岁），将研究对象分为2个亚组，即小于等于60岁和大于等于61岁两组，单变量分析显示随着年龄的增加，死亡风险增加（P = .019）。而多因素分析显示，年龄增加作为食管癌患者的独立预后因素（P = .041）。包括30天死亡率对研究结果没有影响。与年轻患者相比，年龄越大，其外科并发症明显增加，体现在以下几个方面：吸入性肺炎，成人呼吸窘迫综合症，心血管，神经系统以及多系统并发症。

结论：该研究显示，与年龄大于70岁的患者相比，年龄低于60岁（包括60岁）且接受了外科手术的食管癌患者有较好的总生存时间及较少的手术并发症。提示年龄在患者是否接受食管癌手术时作为重要的参考指标。

2009-10-23 21:57

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dr_duran 编辑于 2009-10-23 22:44

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