Comparison of long-term outcome between hemicolectomy and partial colectomy in the elderly: a large population-based study
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Xu Guan1,2,*, Hanqing Hu1,*, Wei Chen3, Zheng Jiang2, Zheng Liu2, Zhixun Zhao1, Yinggang Chen1, Guiyu Wang1 and Xishan Wang1,2
1Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
2Department of Colorectal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
3Follow Up Center, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
*These authors have contributed equally to this work
Xishan Wang, email: email@example.com
Guiyu Wang, email: firstname.lastname@example.org
Yinggang Chen, email: email@example.com
Keywords: colon cancer, surgery, colectomy, elderly, survival
Received: September 23, 2016 Accepted: February 21, 2017 Published: April 10, 2017
Due to large progress has been achieved in surgical techniques, anesthesia and perioperative care, it is accepted that the very elderly colon cancer (CC) patient is not contraindication for surgery. However, it is a controversy that an extended or a less aggressive surgical approach should be performed for this population. Here, we identified 28110 CC patients aged ≥80 from Surveillance, Epidemiology, and End-Results (SEER) database. The surgical approaches included extended hemicolectomy (HC) and partial colectomy (PC). 5-year cancer specific survival (CSS) was obtained. Kaplan–Meier methods and Cox regression models were used to assess the correlations between prognostic factors and long-term survival. The 5-year CSS for patients treated with HC were 45.6%, which were similar to patients who received PC (44.8%), the survival difference has no statistical significance (P=0.087). The result following propensity score matching further confirmed long-term survival were equal between HC and PC. However, patients in AJCC T3/T4 stage and with tumor size ≥5cm could obtain survival benefit from the extended surgery. In conclusion, most of elderly CC patients could not obtain survival benefit from extended resection. Partial colectomy should also be considered as an alternative approach for this group of patients.
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