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Abstract：
BACKGROUND: To evaluate the clinical value of serum CEA levels and their implications on the diagnostic value of the conventional TNM staging system in the oldest-old patients with colorectal cancer (CRC).
METHODS: The recruited subjects were colorectal cancer patients aged 85 and older. The cutoff value for normal CEA level is 5 ng/mL. Patients with elevated CEA levels were categorized as stage C1, and those with normal CEA levels as stage C0. A number of Cox proportional hazard regression models were established to evaluate the prognosis of different prognostic factors with hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan-Meier method was utilized to display the disparate prognostic impact of multiple clinicopathological factors with the log-rank test.
RESULTS: A total of 17,359 oldest-old patients diagnosed with CRC were recruited from the SEER database. The conditional survival of oldest-old patients with CRC was dismal with a 1-year conditional survival of only 11%, 18%, and 30% for patients surviving 1, 3, and 5 years, respectively. Patients with stage C1 exhibited a 48.5% increased risk of CRC-specific mortality compared with stage C0 (HR = 1.485, 95%CI = 1.393-1.583, using stage C0 patients as the reference, P < 0.001). All the stage C0 patients indicated lower HRs relative to the corresponding stage C1 patients.
CONCLUSIONS: Dismal conditional survival of oldest-old patients with CRC should be given additional consideration. C stage influences the prognosis of oldest-old patients with CRC.
METHODS: The recruited subjects were colorectal cancer patients aged 85 and older. The cutoff value for normal CEA level is 5 ng/mL. Patients with elevated CEA levels were categorized as stage C1, and those with normal CEA levels as stage C0. A number of Cox proportional hazard regression models were established to evaluate the prognosis of different prognostic factors with hazard ratios (HRs) and 95% confidence intervals (CIs). The Kaplan-Meier method was utilized to display the disparate prognostic impact of multiple clinicopathological factors with the log-rank test.
RESULTS: A total of 17,359 oldest-old patients diagnosed with CRC were recruited from the SEER database. The conditional survival of oldest-old patients with CRC was dismal with a 1-year conditional survival of only 11%, 18%, and 30% for patients surviving 1, 3, and 5 years, respectively. Patients with stage C1 exhibited a 48.5% increased risk of CRC-specific mortality compared with stage C0 (HR = 1.485, 95%CI = 1.393-1.583, using stage C0 patients as the reference, P < 0.001). All the stage C0 patients indicated lower HRs relative to the corresponding stage C1 patients.
CONCLUSIONS: Dismal conditional survival of oldest-old patients with CRC should be given additional consideration. C stage influences the prognosis of oldest-old patients with CRC.
摘要：
背景：评估血清CEA水平的临床价值及其对年龄最大的结直肠癌（CRC）患者常规TNM分期系统的诊断价值的意义。
方法：招募的受试者为85岁及以上的结直肠癌患者。正常CEA水平的截止值为5ng/mL。CEA水平升高的患者被归类为C1期，CEA水平正常的患者被归类为C0期。建立多个Cox比例风险回归模型，以风险比（HRs）和95％置信区间（CIs）评估不同预后因素的预后。Kaplan-Meier方法用于通过对数秩检验显示多个临床病理因素的不同预后影响。
结果：从SEER数据库中招募了17,359名诊断为CRC的年龄最大的患者。年龄最大的CRC患者的条件生存率令人沮丧，1年条件生存率仅为11％。18%,对于存活1年、3年和5年的患者，分别。与C0期相比，C1期患者的CRC特异性死亡率风险增加48.5%（HR=1.485，95CI=1.393-1.583，以C0期患者为参考，P<0.001)。所有C0期患者相对于相应的C1期患者显示较低的HR。
结论：应进一步考虑年龄最大的CRC患者的条件生存。C分期影响年龄最大的CRC患者的预后。
方法：招募的受试者为85岁及以上的结直肠癌患者。正常CEA水平的截止值为5ng/mL。CEA水平升高的患者被归类为C1期，CEA水平正常的患者被归类为C0期。建立多个Cox比例风险回归模型，以风险比（HRs）和95％置信区间（CIs）评估不同预后因素的预后。Kaplan-Meier方法用于通过对数秩检验显示多个临床病理因素的不同预后影响。
结果：从SEER数据库中招募了17,359名诊断为CRC的年龄最大的患者。年龄最大的CRC患者的条件生存率令人沮丧，1年条件生存率仅为11％。18%,对于存活1年、3年和5年的患者，分别。与C0期相比，C1期患者的CRC特异性死亡率风险增加48.5%（HR=1.485，95CI=1.393-1.583，以C0期患者为参考，P<0.001)。所有C0期患者相对于相应的C1期患者显示较低的HR。
结论：应进一步考虑年龄最大的CRC患者的条件生存。C分期影响年龄最大的CRC患者的预后。
