This work investigates the prognostic role of advanced age as a risk factor for recurrence in a population of patients undergoing surgery for N0 stage colon cancer, and also evaluates whether that role is affected by tumor location. A population of 129 con- secutive patients who underwent radical surgery for N0 stage colon cancer was selected. Patients were subdi- vided into three age groups: <65, 65-80 and >80. The only correlation found in the examined population between age and clinical-pathological features was be- tween advanced age (>80) and tumor location in the right side of the colon. Overall survival (OS) and dis- ease-free survival (DFS) were significantly lower in pa- tients over 80 than in the other two classes. Two mul- tivariate analyses were carried out: when tumor loca- tion was not considered, age >80 represented a neg- ative prognostic factor for risk of recurrence, regardless of the other factors examined. This role was also con- firmed when tumor location was considered. As hy- pothesized by several authors, the role of advanced age which emerges from this study is mainly due to the in- creased fragility of elderly patients caused by multiple pathophysiological factors, but it does not necessarily represent an absolute contraindication to surgery. The role played by tumor location remains contro- versial, as more and more studies show that right colon cancer (RCC) is a biological entity distinct from left colon cancer (LCC). Further studies are required to examine right and left colon cancers as two separate diseases.
N0 Stage colon cancer: prognostic role of age in relation to tumor site.
Claudio Terranova;MILITELLO, CARMELO
2012
Abstract
This work investigates the prognostic role of advanced age as a risk factor for recurrence in a population of patients undergoing surgery for N0 stage colon cancer, and also evaluates whether that role is affected by tumor location. A population of 129 con- secutive patients who underwent radical surgery for N0 stage colon cancer was selected. Patients were subdi- vided into three age groups: <65, 65-80 and >80. The only correlation found in the examined population between age and clinical-pathological features was be- tween advanced age (>80) and tumor location in the right side of the colon. Overall survival (OS) and dis- ease-free survival (DFS) were significantly lower in pa- tients over 80 than in the other two classes. Two mul- tivariate analyses were carried out: when tumor loca- tion was not considered, age >80 represented a neg- ative prognostic factor for risk of recurrence, regardless of the other factors examined. This role was also con- firmed when tumor location was considered. As hy- pothesized by several authors, the role of advanced age which emerges from this study is mainly due to the in- creased fragility of elderly patients caused by multiple pathophysiological factors, but it does not necessarily represent an absolute contraindication to surgery. The role played by tumor location remains contro- versial, as more and more studies show that right colon cancer (RCC) is a biological entity distinct from left colon cancer (LCC). Further studies are required to examine right and left colon cancers as two separate diseases.Pubblicazioni consigliate
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