根据患者的年龄，结直肠疾病的特征也有所不同。本研究使用一个大型国家数据库，评估了结直肠癌的特征和治疗在不同年龄组的差异，并评估年龄对结果的影响。本研究回顾性分析了2005年至2019年间在美国国家癌症数据库中进行结直肠癌手术切除的患者队列。患者分为三个年龄组：早年发病组（<50岁）、中年组（50-79岁）和高龄组（≥80岁）。评估了各组肿瘤特征的差异。主要的研究结果包括临床和治疗特征以及短期死亡率。总共纳入了662,102例结肠癌患者和114,460例直肠癌患者，36.1%的年轻结肠癌患者存在转移性疾病。相比其他两个年龄组，老年患者更常接受开腹手术，较少接受化疗和放疗。与中年和年轻患者相比，高龄患者的住院时间更长，且结直肠癌手术后30天的死亡率显著增高（结肠癌：7.6% vs 2.4% vs 0.7%；P < .001；直肠癌：5.9% vs 1.3% vs 0.3%；P < .001），结直肠癌手术后90天的死亡率也显著增高（结肠癌：12.9% vs 4.6% vs 1.7%；P < .001；直肠癌：10.3% vs 2.6% vs 0.7%；P < .001）。与其他两个组相比，老年患者的总生存期显著缩短，无论病理分期、Charlson-Deyo合并症评分或肿瘤位置如何。本研究发现了与年龄相关的结直肠癌特征、治疗和结果的显著差异。认识到这些差异可以是减少与年龄相关的治疗差异的第一步。版权所有 © 2023 Elsevier Inc. 保留所有权利。

Characteristics of colorectal diseases may vary according to the patient's age. By using a large national database, we assessed age-related differences in characteristics and treatments of colorectal cancer and to evaluate the influence of age on outcomes.Retrospective cohort analysis of all patients who underwent surgical resection for colorectal cancer in the US National Cancer Database between 2005 and 2019. Patients were divided into 3 age groups: young age onset (<50 years), middle age group (50-79 years), and very old (≥80 years). Differences in tumor characteristics among groups were assessed. The main outcomes were clinical and treatment characteristics and short-term mortality.In total, 662,102 patients with colon cancer and 114,460 with rectal cancer were included-36.1% of young patients with colon cancer presented with metastatic disease. Older patients underwent open surgery more often and received chemotherapy and radiation therapy less often than did the other 2 groups regarding disease stage. Very old patients, compared to middle-aged and young patients, had longer hospitalization and significantly higher rates of 30-day mortality after colon (7.6% vs 2.4% vs 0.7%; P < .001) and rectal (5.9% vs 1.3% vs 0.3%; P < .001) cancer surgery and higher 90-day mortality after colon (12.9% vs 4.6% vs 1.7% P < .001) and rectal (10.3% vs 2.6% vs 0.7%; P < .001) cancer surgery.Older patients had significantly shorter overall survival than the other 2 groups, regardless of pathologic stage, Charlson -Deyo comorbidity score, or tumor side.Significant age-related disparities in characteristics, treatments, and outcomes of colorectal cancer were found in this study. Recognizing these differences can be the first step toward reducing age-related treatment differences.Copyright © 2023 Elsevier Inc. All rights reserved.