| Popis: |
Background Colorectal cancer is one of the four most common cancers in the world. At present, Human beings have stepped into an aging society, and the number of over eighties colorectal cancer patients has increased year by year. However, few high-quality studies focused on the post-operation complications and long term outcomes of octogenarian patients with colorectal cancer. This meta-analysis based on published studies aims to assess the safety of treating octogenarian CRC patients with surgery. Methods Databases, including PubMed, Embase, and Cochrane Library were searched until July 2022. The incidence of preoperative comorbidities, postoperative complications, and mortality was assessed using odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Furthermore, the hazard ratios (HRs) with 95% CIs were applied for survival outcomes. Results A total of 13,790 patients with CRC in 21 studies were included. Our results demonstrated that octogenarian patients were associated with a higher burden of comorbidities (OR = 3.03;95% CI: 2.03, 4.53༛P = .000), high incidences of overall postoperative complications (OR = 1.63༛95% CI༚1.29,2.06༛P = .000), high internal medicine postoperative complications (OR = 2.38༛95% CI༚1.76, 3.21༛P = .000), high in-hospital mortality (OR = 4.01༛95% CI༚3.06, 5.27༛P = .000) and poor overall survival (OR = 2.13༛95% CI༚1.78, 2.55༛P = .000).But there is no statistical difference in surgery-related postoperative complications(OR = 1.16༛95% CI༚0.94, 1.43༛P = .16) and DFS༈OR = 1.03༛95% CI༚0.83, 1.29༛P = .775). Conclusions Considering the high burden of comorbidities, high incidences of postoperative complications and mortality, surgery for extremely elderly patients with CRC requires deliberation. Nevertheless, the survival outcomes of octogenarian and even older patients is similar to those of youth patients. Some of them might benefit from conservative treatments or palliative surgeries indeed. Hereby, individualized treatment is recommended for such patients. Instead of actual age, physical age is the real element the clinicians should take into consideration. |
