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This retrospective cohort study aimed to discuss the prognostic value of p53 positive in colorectal cancer. A total of 124 consecutive patients diagnosed with colorectal cancer were evaluated at the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from 1 January 2009 to 31 December 2010. The expression of p53 in colorectal cancer was examined by immunohistochemistry. Based on the expression levels of p53, the 124 patients were divided into a p53 positive group and a p53 negative group. In this study, 72 patients were in the p53 positive group and 52 in the p53 negative group. The two groups were well balanced in gender, age, body mass index, American Society of Anesthesiologists scores, and number of lymph nodes harvested. p53 positive was associated with carcinoembryonic antigen ≥5 ng/mL ( p = 0.036), gross type ( p = 0.037), degree of tumor differentiation ( p = 0.026), pathological tumor stage ( p = 0.019), pathological node stage ( p = 0.004), pathological tumor-node-metastasis stage ( p = 0.017), nerve invasion ( p = 0.008), and vessel invasion ( p = 0.018). Tumor site, tumor size, and pathological pattern were not significantly different between these two groups. Disease-free survival and overall survival in the p53 positive group were significantly shorter than the p53 negative group ( p = 0.021 and 0.025, respectively). Colorectal cancer patients with p53 positive tended to be related to a higher degree of malignancy, advanced tumor-node-metastasis stage, and shorter disease-free survival and overall survival. p53 positive was independently an unfavorable prognostic marker for colorectal cancer patients.

Objective To investigate the surgical treatment strategy for colorectal cancer patients with ileus aged over 80 years old. Methods We retrospectively collected and analyzed the clinicopathological data of patients with preoperative ileus aged over 80 years old who underwent colorectal cancer surgery from January 2007 to December 2018. According to the surgical method, the patients were divided into the radical surgery group (n=58) and the non-radical surgery group (n=19). The clinicopathological characteristics, perioperative indicators and prognosis of the two groups were compared. Kaplan-Meier method was used for survival analysis and Cox regression analysis was conducted to analyze prognostic factors. Results A total of 77 patients were included. The proportion of patients with stage Ⅳ in the radical treatment group was significantly lower than that in the non-radical treatment group (P < 0.001). The 5-year survival rate of the radical surgery group was significantly higher than that of the non-radical surgery group (P < 0.001). Univariate analysis showed that the predictors for survival were TNM stage and radical surgery. Multivariate analysis showed that radical surgery was an independent factor affecting the prognosis of colorectal cancer patients with ileus aged over 80 years old. Conclusion Radical surgery is an independent factor affecting the prognosis of colorectal cancer patients with ileus aged over 80 years old.

Purpose: Cytoreductive surgery (CRS) added with hyperthermic intraperitoneal chemotherapy (HIPEC) can improve the survival rate of certain patients with peritoneal metastasis (PM). However, the perioperative safety and long-term survival of this intricate and possibly life-threatening procedure in elderly patients (≥ 65 years) remain controversial. Methods: Patients with PM due to appendiceal or colorectal tumours who underwent CRS/HIPEC were evaluated systematically at the National Cancer Center of China and the Huanxing Cancer Hospital between June 2017 and June 2019. The recruited subjects were retrospectively categorized into elderly (age ≥ 65) and non-elderly (age< 65) groups according to their age. Clinical and pathological features, postoperative outcomes, and prognoses were gathered and analysed. Results: Both groups had similar overall morbidity (56.0% vs 38.7%, P=0.130) and grade 3/4 morbidity (28.0% vs 20.0%, P=0.403) after CRS/HIPEC. However, more patients in the elderly group suffered from ileus postoperatively (16.0% vs 2.6%, P=0.033). After a follow-up period of a median of 20 months, it was concluded that elderly patients had significantly worse 3-year overall survival (OS) than non-elderly patients (16.3% vs 51.4%, P=0.001). Independent prognostic factors were identified to be a high peritoneal carcinomatosis index (PCI) score (HR, 1.10, 95% CI, 1.04– 1.16; P=0.001) and age ≥ 65 (HR, 2.42, 95% CI, 1.32– 4.45; P=0.004) were independent prognostic factors through cox regression analysis. Conclusion: CRS and HIPEC are related with an elevated prevalence of postoperative ileus but not with the overall morbidity or the grade 3/4 morbidity in elderly patients. However, since worse survival outcomes were observed more commonly in elderly patients compared to younger patients from CRS+HIPEC, this complex and potentially life-threatening procedure should be considered carefully in patients aged ≥ 65 years. [ABSTRACT FROM AUTHOR]