Prognostic Implications of Primary Tumor Resection in Stage IVB Colorectal Cancer in Elderly Patients
안희준, 오호석, Ahn Yong-ChelAhn Yong-Chel, 이상진, 김현중, 김문호, 엄대운, 곽재영, 한명식, 송재석,
소속 상세정보
안희준 ( Ahn Heui-June )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
오호석 ( Oh Ho-Suk )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
( Ahn Yong-ChelAhn Yong-Chel )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
이상진 ( Lee Sang-Jin )
Bundang Jesaeng General Hospital Department of Internal Medicine
김현중 ( Kim Hyun-Joong )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
김문호 ( Kim Moon-Ho )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
엄대운 ( Eom Dae-Woon )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Pathology
곽재영 ( Kwak Jae-Young )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Surgery
한명식 ( Han Myoung-Sik )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Surgery
송재석 ( Song Jae-Seok )
Kwandong University College of Medicine Department of Preventive Medicine
KMID : 0356720140300040175
Abstract
Purpose: The aim of this study was to identify prognostic factors in stage IVB colorectal cancer in elderly patients, focusing on the influence of treatment modalities, including palliative chemotherapy and primary tumor resection.
Methods: A cohort of 64 patients aged over 65 years who presented with stage IVB colorectal cancer at the Gangneung Asan Hospital between July 1, 2001, and December 31, 2009, was analyzed. Demographics, tumor location, tumor grade, performance status, levels of carcinoembryonic antigen (CEA), level of aspartate aminotransferase (AST), and distant metastatic site at diagnosis were analyzed. Using the treatment histories, we analyzed the prognostic implications of palliative chemotherapy and surgical resection of the primary tumor retrospectively.
Results: The cohort consisted of 30 male (46.9%) and 34 female patients (53.1%); the median age was 76.5 years. Primary tumor resection was done on 28 patients (43.8%); 36 patients (56.2%) were categorized in the nonresection group. The median survival times were 12.43 months in the resection group and 3.58 months in the nonresection group (P < 0.001). Gender, level of CEA, level of AST, Eastern Cooperative Oncology Group performance status, tumor location, and presence of liver metastasis also showed significant differences in overall survival. On multivariate analysis, male gender, higher level of CEA, higher AST level, and no primary tumor resection were independent poor prognostic factors. In particular, nonresection of the primary tumor was the most potent/poor prognostic factor in the elderly-patient study group (P = 0.001; 95% confidence interval, 2.33 to 21.99; hazard ratio, 7.16).
Conclusion: In stage IVB colorectal cancer in elderly patients, resection of the primary tumor may enhance survival.
키워드
Colorectal neoplasms;Prognosis;Palliative surgery
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