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Chirurgie des cancers digestifs chez les patients âgés

  • Chapter
Les cancers digestifs du sujet âgé

Part of the book series: Oncologie pratique ((ONCOLPRAT))

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Résumé

Les tumeurs digestives, notamment celles du côlon, du rectum, de l’estomac et du pancréas, sont parmi les tumeurs les plus fréquentes du sujet âgé (1). Compte tenu du vieillissement de la population française et de l’augmentation de l’incidence de ces tumeurs avec l’âge, surtout après 70 ans, la proportion de patients âgés atteints d’un cancer nécessitant une intervention chirurgicale augmente régulièrement (2). On estime qu’aux États-Unis, à partir de 2010, la mortalité par cancer sera en première position devant celle par maladies cardio-vasculaires (3). Physiologiquement, le vieillissement est associé à une perte progressive des capacités de réserve, même chez les individus sans comorbidités apparentes. Le vieillissement est alors surtout visible en cas d’augmentation des besoins métaboliques telle qu’elle se produit après une intervention chirurgicale. Pourtant, la chirurgie d’exérèse reste le traitement de référence des tumeurs digestives, permettant d’obtenir des survies prolongées et un espoir de guérison.

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Références

  1. Kemeny M, Busch-Devereaux E, Merriam L, O’Hea B (2000) Cancer surgery in the elderly. Hematol Oncol Clin North Am 14: 169–92

    Article  CAS  PubMed  Google Scholar 

  2. Ahlgren J (1999) Gastrointestinal cancer in the elderly. Clin Geriatr Med 15: 627–40

    CAS  PubMed  Google Scholar 

  3. Lee R, Miller T (2002) An approach to forecasting health expenditures, with application to the U.S. Medicare system. Health Serv Res 37: 1365–86

    Article  PubMed  Google Scholar 

  4. Samet J, Hunt W, Key C et al. (1986) Choice of cancer therapy varies with age of patient. JAMA 255: 3385–90

    Article  CAS  PubMed  Google Scholar 

  5. Bailey C, Corner J, Addington-Hall J et al. (2003) Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function. Eur J Cancer Care (Engl) 12: 257–62

    Article  CAS  Google Scholar 

  6. Wu C, Lo S, Shen K et al. (2000) Surgical mortality, survival, and quality of life after resection for gastric cancer in the elderly. World J Surg 24: 465–72

    Article  CAS  PubMed  Google Scholar 

  7. Manku K, Bacchetti P, Leung JM (2003) Prognostic significance of postoperative in-hospital complications in elderly patients. I. Long-term survival. Anesthesia & Analgesia 96: 583–9

    Article  Google Scholar 

  8. Bufalari A, Ferri M, Cao P et al. (1996) Surgical care in octogenerains. Br J Surg 83: 1783–7

    Article  CAS  PubMed  Google Scholar 

  9. Law WL, Chu KW, Tung PH (2002) Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 195: 768–73

    Article  PubMed  Google Scholar 

  10. Jessup J, McGinnis L, Jr GS et al (1996) The National Caner Data Base report on colon cancer. Cancer 78: 913–26

    Google Scholar 

  11. Kemppainen M, Raiha I, Rajala T, Sourander L (1993) Characteristics of colorectal cancer in elderly patients. Gerontology 39: 222–7

    Article  CAS  PubMed  Google Scholar 

  12. Group CCC (2000) Surgery for colorectal cancer in elderly patients: a systematic review. Lancet 356: 968–74

    Article  Google Scholar 

  13. Lindmark G, Pahlman L, Anblad P, Glimelius B (1988) Surgery for colorectal cancer in elderly patients. Acta Chir Scand 154: 659–63

    CAS  PubMed  Google Scholar 

  14. Fielding L, Philips R, Hittinger R (1989) Factors influencing mortality after curative resection for large bowel cancer in elderly patients. Lancet 8638: 595–7

    Article  Google Scholar 

  15. Stocchi L, Nelson H, Young-Fadok T et al. (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly. Dis Colon Rectum 43: 326–32

    Article  CAS  PubMed  Google Scholar 

  16. Schwandner O, Schiedeck THK, Bruch HP (1999) Advanced age-indication or contraindication for laparoscopic colorectal surgery? Dis Côlon Rectum 42: 356–62

    Article  CAS  PubMed  Google Scholar 

  17. Law WL, Lee YM, Choi HK et al. (2007) Impact of laparoscopic resection for colorectal cancer on operative outcomes and survival. Ann Surg 245: 1–7

    Article  PubMed  Google Scholar 

  18. Chang GJ, Skibber JM, Feig BW, Rodriguez-Bigas M (2007) Are we undertreating rectal cancer in the elderly? An epidemiologic study. Ann Surg 246: 215–21

    Article  PubMed  Google Scholar 

  19. Nordlinger B, Jaeck D (1992) Traitement des métastases hépatiques des cancers colorectaux. Monographie de L’association Française de Chirurgie._Paris, Springer-Verlag

    Google Scholar 

  20. Fong Y, Brennan M, Cohen A et al. (1997) Liver resection in the elderly. Br J Surg 84: 1386-90

    Google Scholar 

  21. Mann CD, Neal CP, Pattenden CJ et al. (2008) Major resection of hepatic colorectal liver metastases in elderly patients — An aggressive approach is justified. Eur J Surg Oncol 34: 428–32

    CAS  PubMed  Google Scholar 

  22. Ettorre GM, Sommacale D, Farges O et al. (2001) Postoperative liver function after elective right hepatectomy in elderly patients. Br J Surg 88: 73–6

    Article  CAS  PubMed  Google Scholar 

  23. Koperna T, Kisser M, Schulz F (1998) Hepatic resection in the elderly. World J Surg 22: 406–12

    Article  CAS  PubMed  Google Scholar 

  24. Fong Y, Cohen A, Fortner J et al. (1997) Liver resection for colorectal metastases. J Clin Oncol 15: 938–46

    CAS  PubMed  Google Scholar 

  25. Amamoto K, Takenaka K, Matsumata T, et al. (1997) Right hepatic lobectomy in elderly patients with hepatocellular carcinoma. Hepatogastroenterology 44: 514–8

    Google Scholar 

  26. Niederhuder J, Brennan M, Menck H (1995) The National Cancer Data Base report on pancreatic cancer. Cancer 76: 1671–7

    Article  Google Scholar 

  27. Lerut J, Gianello P, Otte J, Kestens P (1984) Pancreaticoduodenal resection. Ann Surg 199: 432–7

    Article  CAS  PubMed  Google Scholar 

  28. Baumel H, Huguier M, Manderscheid J et al. (1994) Results of resection for cancer of the exocrine pancreas: a study from the french Association of Surgery. Br J Surg 81: 102–7

    Article  CAS  PubMed  Google Scholar 

  29. Sharaf K, Andrén-Sandberg A, Ihse I (1999) Subtotal pancreatectomy for cancer can be safe in the elderly. Eur J Surg 165: 230–5

    Article  Google Scholar 

  30. McPhee JT, Hill JS, Whalen GF et al. (2007) Perioperative mortality for pancreatectomy: a national perspective. Ann Surg 246: 246–53

    Article  PubMed  Google Scholar 

  31. Finlayson EV, Goodney PP, Birkmeyer JD (2003) Hospital volume and operative mortality in cancer surgery: a national study. Arch Surg 138: 721–5; discussion 6

    Article  PubMed  Google Scholar 

  32. DiCarlo V, Balzano G, Zerbi A, Villa E (1998) Pancreatic cancer resection in elderly patients. Br J Surg 85: 607–10

    Article  CAS  PubMed  Google Scholar 

  33. Tsiotos G, Farnell M, Sarr M (1999) Are the results of pancreatectomy for pancreatic cancer improving? Word J surg 23: 913–9

    Article  CAS  Google Scholar 

  34. Wamebo H, Kennedy B, Chmiel J et al. (1993) Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 218: 583–92

    Article  Google Scholar 

  35. Bandoh T, Isoyama T, Toyoshima H (1991) Total gastrectomy for gastric cancer in elderly. Surgery 109: 136–42

    CAS  PubMed  Google Scholar 

  36. Meyer C, Lozac’h P (1998) Le cancer de l’estomac. Monographie de l’Association Française de Chirurgie, Arnette Paris

    Google Scholar 

  37. Macintyre I, Akoh J (1991) Improving survival in gastric cancer: review of operative mortality in English language publications from 1970. Br J Surg 78: 773–8

    Article  Google Scholar 

  38. Bittner R, Butters M, Ulrich M, et al. (1996) Total gastrectomy. Update operative mortality and long term survival with particular reference to patients older than 70 years of age. Ann Surg 224: 37–42

    Article  CAS  PubMed  Google Scholar 

  39. Korenaga D, Moriguchi S, Baba H et al. (1991) Surgery for gastic carcinoma is feasible for patients over 80 years of age. World J Surg 15: 647–8

    Article  Google Scholar 

  40. Hara H, Isozoka H, Nomura E et al. (1999) Evaluation of treatment strategies for gastric cancer in the elderly according to the number of abnormal parameters on preoperative examination. Surg Today 29: 837–41

    Article  CAS  PubMed  Google Scholar 

  41. Asao T, Hosouchi Y, Nakabayashi T et al. (2001) Laparoscopically assisted total or distal gastrectomy with lymph node dissection for early gastric cancer. Br J Surg 88: 128–32

    Article  CAS  PubMed  Google Scholar 

  42. Yasuda K, Sonoda K, Shiroshita H et al. (2004) Laparoscopically assisted distal gastrectomy for early gastric cancer in the elderly. Br J Surg 91: 1061–5

    Article  CAS  PubMed  Google Scholar 

  43. Huscher CG, Mingoli A, Sgarzini G et al. (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241: 232–7

    Article  PubMed  Google Scholar 

  44. Singh KK, Rohatgi A, Rybinkina I et al. (2008) Laparoscopic gastrectomy for gastric cancer: early experience among the elderly. Surg Endosc 22: 1002–7

    Article  CAS  PubMed  Google Scholar 

  45. Thomas P, Doddoli C, Neville P et al. (1996) Esophageal cancer resection in the elderly. Eur J Cardiothorac Surg 10: 941–6

    Article  CAS  PubMed  Google Scholar 

  46. Ellis F, Williamson W, Heatley G (1998) Cancer of the esophagus and cardia: does age influence treatment selection and surgical outcomes. J Am Coll Surg 187: 345–51

    Article  PubMed  Google Scholar 

  47. Xijiang Z, Xizeng Z, Xishan H, Hongjing J (1999) Surgical treatment for carcinoma of the esophagus in the elderly patients. Ann Thorac Cardiovasc Surg 5: 182–6

    CAS  PubMed  Google Scholar 

  48. Alexiou C, Beggs D, Salama D et al. (1998) Surgery for esophageal cancer in the elderly patients: the view from nottigham. J Thor Cardiovascular Surg 116: 545–53

    Article  CAS  Google Scholar 

  49. Poon R, Law S, Chu K et al. (1998) Esophagectomy for carcinoma if the esophagus in the elderly: results of current surgical management. Ann Surg 227: 357–64

    Article  CAS  PubMed  Google Scholar 

  50. Keeling P, Gillen P, Hennessy T (1988) Oesophageal resection in the elderly. Ann R Coll Surg Engl 70: 34–7

    CAS  PubMed  Google Scholar 

  51. Barbier P, Muller K, Wagner H, Berchtold R (1985) Esophageal carcinoma: surgery using transhiatal esophagectomy without thoracotomy. Schweizerische Medizinische Wochenschrift 19: 9–15

    CAS  PubMed  Google Scholar 

  52. Ma JY, Wu Z, Wang Y et al. (2006) Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients. World J Gastroenterol 12: 1296–9

    PubMed  Google Scholar 

  53. Ruol A, Portale G, Castoro C et al. (2007) Management of esophageal cancer in patients aged over 80 years. Eur J Cardiothorac Surg 32: 445–8

    Article  PubMed  Google Scholar 

  54. Shimada H, Shiratori T, Okazumi S et al. (2007) Surgical outcome of elderly patients 75 years of age and older with thoracic esophageal carcinoma. World J Surg 31: 773–9

    Article  PubMed  Google Scholar 

  55. Ruol A, Portale G, Castoro C et al. (2007) Effects of neoadjuvant therapy on perioperative morbidity in elderly patients undergoing esophagectomy for esophageal cancer. An Surg Oncol 14: 3243–50

    Article  Google Scholar 

  56. Finlayson E, Fan Z, Birkmeyer JD (2007) Outcomes in octogenarians undergoing high-risk cancer operation: a national study. J Am Coll Surg 205: 729–34

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service de chirurgie viscérale, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex

    Philippe Wind & Joseph Benichou

  2. Service de chirurgie digestive, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex

    Kakanou Alain Ekeuh

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Wind, P., Ekeuh, K.A., Benichou, J. (2010). Chirurgie des cancers digestifs chez les patients âgés. In: Les cancers digestifs du sujet âgé. Oncologie pratique. Springer, Paris. https://doi.org/10.1007/978-2-8178-0000-4_4

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  • DOI: https://doi.org/10.1007/978-2-8178-0000-4_4

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-79513-8

  • Online ISBN: 978-2-8178-0000-4

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