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Efficacy of Surgery...
Efficacy of Surgery and Adjuvant Therapy in Older Patients With Colorectal Cancer A STROBE-compliant article
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- Yang, Lie (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Ma, Qin (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Yu, Yong-Yang (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Wang, Cun (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Meng, Wen-Jian (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Adell, Gunnar (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Onkologiska kliniken US,Kirurgiska kliniken ViN
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- Albertsson, Maria (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Onkologiska kliniken US
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- Arbman, Gunnar (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Kirurgiska kliniken ViN
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- Jarlsfelt, Ingvar (author)
- Jonköping Hospital, Sweden
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- Peng, Zhi-Hai (author)
- Shanghai Jiao Tong University, Peoples R China
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- Li, Yuan (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Zhou, Zong-Guang (author)
- Sichuan University, Peoples R China; Sichuan University, Peoples R China
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- Sun, Xiao-Feng (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kliniska vetenskaper,Hälsouniversitetet,Onkologiska kliniken US,Sichuan University, Peoples R China; Sichuan University, Peoples R China
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(creator_code:org_t)
- Lippincott, Williams andamp; Wilkins, 2014
- 2014
- English.
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In: Medicine. - : Lippincott, Williams andamp; Wilkins. - 0025-7974 .- 1536-5964. ; 93:28
- Related links:
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- The present study aimed to assess the efficacy of surgery and adjuvant therapy in older patients (age greater than= 70 years) with colorectal cancer (CRC). Older CRC patients are under-represented in available clinical trials, and therefore their outcomes after receiving surgery and adjuvant therapy are unclear. From two prospective Swedish databases, we assessed a cohort of 1021 patients who underwent curative surgery for stage I, II, or III primary CRC, with or without adjuvant chemotherapy/ radiotherapy. Of the patients with colon cancer (n = 467), 182 (39%) were aged less than70 years, 162 (35%) aged 70 to 80 years, and 123 (26%) were aged greater than= 80 years. Of rectal cancer patients (n = 554), 264 (48%) were aged less than70 years, 234 (42%) aged 70 to 80 years, and 56 (10%) aged greater than= 80 years. Older patients with either colon or rectal cancer had higher comorbidity than did younger patients. Older patients with colon cancer had equivalent postoperative morbidity and 30-day mortality to younger patients. Rectal cancer patients aged greater than= 80 years had a higher 30-day mortality than younger patients (odds ratio OR], 2.37; 95% confidence interval CI], 1.6-4.55; P = 0.03). For either colon or rectal cancer, adjuvant chemotherapy compromised the 5-year overall survival (OS) of older patients with stage II disease and had no effect on those with stage III disease. Receiving adjuvant chemotherapy was a poor factor of OS for older patients with either colon (HR 1.88, 95% CI: 1.20-4.35, P = 0.03) or rectal cancer (HR 1.72, 95% CI: 1.052.26, P = 0.004). Preoperative short-course radiotherapy improved both OS and local control for older patients with stage III rectal cancer and had no effect on those with stage II disease. Radiotherapy was a favorable factor for the OS of the older patients with rectal cancer (HR 0.42, 95% CI: 0.21-3.57, P = 0.01). In conclusion, Older CRC patients had equal safety of surgery as younger patients, except rectal cancer patients aged greater than= 80 years that had a higher mortality. Adjuvant 5FU-based chemotherapy did not benefit older CRC patient, while neoadjuvant radiotherapy improved the prognosis of older patients with stage III rectal cancer.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- colorectal neoplasm; surgery; adjuvant chemotherapy; neoadjuvant radiotherapy; survival; recurrence
Publication and Content Type
- ref (subject category)
- art (subject category)
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Medicine
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- By the author/editor
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Yang, Lie
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Ma, Qin
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Yu, Yong-Yang
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Wang, Cun
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Meng, Wen-Jian
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Adell, Gunnar
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show more...
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Albertsson, Mari ...
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Arbman, Gunnar
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Jarlsfelt, Ingva ...
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Peng, Zhi-Hai
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Li, Yuan
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Zhou, Zong-Guang
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Sun, Xiao-Feng
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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Medicine
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Linköping University