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Chinese Journal of Oncology Prevention and Treatment ›› 2018, Vol. 10 ›› Issue (4): 299-304.doi: 10.3969/j.issn.1674-5671.2018.04.11

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Effect of preoperative chemotherapy with oxaliplatin on postoperative cognitive dysfunction in elderly patients with gastrointestinal cancer

  

  • Online:2018-08-25 Published:2018-09-25

Abstract:

Objective  To investigate the effect of preoperative chemotherapy with oxaliplatin on postoperative cognitive dysfunction(POCD) in elderly patients with gastrointestinal cancer. Methods 100 eligible individuals undergoing elective radical resection for gastric, colorectal and rectal carcinoma with total intravenous anesthesia were randomly assigned into two groups according to the history of preoperative chemotherapy with oxaliplatin: preoperative chemotherapy group(group PC) and non-preoperative chemotherapy group(group NC), while 25 elderly healthy volunteers served as the controlled group(group C). The neuropsychological tests were performed to assess the cognitive function in surgical groups at 7 days after surgery,and  a multivariate Logistic regression model was conducted to analyze the risk factors of POCD. Results A total of 46 patients in group PC, 48 patients in group NC and 25 volunteers in group C completed neuropsychological tests. Compared with results at 8th day of neuropsychological tests in group C, scores of visual verbal learning test and letter-digit coding test were significantly declined, completion time of concept shifting test and stroop color word test were significantly increased in patients group(P<0.05). Compared with group NC, at 7 day after surgery, PC group showed lower visual verbal learning test(short-term memory) and letter-digit coding test scores(P<0.05), higher POCD rates (45.7% vs 25.0%,P<0.05), and longer hospital stays (P<0.05). Multivariate Logistic analysis showed that age (≥75 years) and preoperative chemotherapy with oxaliplatin were the independent risk factors of POCD after surgery. Conclusions  Preoperative chemotherapy with oxaliplatin in elderly patients with gastrointestinal cancer may increase the incidence of POCD, and prolong the postoperative length of hospital stay.

Key words: Gastric neoplasms, Intestinal neoplasms, Oxaliplatin, Preoperative chemotherapy, Postoperative cognitive dysfunction, Elderly patients