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[目的]探讨70岁以上老年结直肠癌患者临床特点及预后。[方法]回顾性分析273例年龄≥70岁的老年结直肠癌患者的临床资料。[结果]70岁以上的新发老年结直肠癌患者占同期住院结直肠癌患者的29.4%(273/927),伴随有基础疾病者205例(75.1%),癌胚抗原(CEA)异常92例(33.7%),D-二聚体异常129例(47.3%),血小板增高89例(32.6%)。病理类型以中分化腺癌居多,116例(42.5%);病理分期以Ⅲ、Ⅳ期为主,Ⅲ期109例(39.9%),Ⅳ期130例(47.6%);远处转移中单发转移78例(60.0%),多发转移52例(40.0%);肝转移92例(70.8%),肝外转移38例(29.2%)。接受手术治疗190例(69.6%),接受化疗171例(62.6%),接受放疗85例(31.1%),仅行姑息支持治疗68例(24.9%)。患者中位生存时间30个月,1年生存率为85.7%(234/273),3年生存率为60.8%(166/273),5年生存率为30.8%(84/273)。69例(36.5%)死于肿瘤进展,98例(51.9%)死于其他基础疾病。[结论 ]老年结直肠癌患者,尤其70岁以上患者,伴随的基础疾病、合并症增多,对于这部分患者既要进行个体化抗肿瘤治疗,又要兼顾伴随疾病的管理。规范化个体化治疗能使患者生存期延长。
[Objective] To investigate the clinical features and prognosis of elderly patients with colorectal cancer over 70 years old. [Methods] The clinical data of 273 elderly patients with colorectal cancer over 70 years old were retrospectively analyzed. [Results] The incidence of newly diagnosed colorectal cancer patients over 70 years old was 29.4% (273/927) in the same period of hospitalized patients with colorectal cancer, 205 cases (75.1%) with underlying diseases, abnormal CEA 92 129 cases (47.3%) had abnormal D-dimer and 89 cases (32.6%) had thrombocytopenia. The majority of pathological types were moderately differentiated adenocarcinoma (116 cases, 42.5%). The pathological stage was mainly in stages Ⅲ and Ⅳ, 109 cases (39.9%) in stage Ⅲ and 130 cases (47.6%) in stage Ⅳ. Metastasis in 78 cases (60.0%), multiple metastases in 52 cases (40.0%); liver metastases in 92 cases (70.8%), extrahepatic metastasis in 38 cases (29.2%). Of the 190 patients (69.6%) who received surgery, 171 received chemotherapy (62.6%), 85 received radiation (31.1%), and 68 received palliative support (24.9%). The median survival time was 30 months. The 1-year survival rate was 85.7% (234/273). The 3-year survival rate was 60.8% (166/273). The 5-year survival rate was 30.8% (84/273). 69 (36.5%) died of tumor progression and 98 (51.9%) died of other underlying diseases. [Conclusion] The elderly patients with colorectal cancer, especially in patients over 70 years old, accompanied by an increase in underlying diseases, comorbidities, for this part of the patient not only to be individualized anti-tumor treatment, but also take into account the management of the disease. Standardized individualized treatment can prolong the survival of patients.