Synchronous colorectal liver metastases: focus on the elderly : An Effectiveness Study from Routine Care.
Langenbecks Arch Surg
; 402(8): 1223-1232, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28803383
ABSTRACT
PURPOSE:
The goal of this study was to analyze the use and the effectiveness of both surgery and different chemotherapies in patients with synchronous colorectal liver metastases (CLMs) ≥70 years compared to younger patients.METHODS:
Survival was analyzed in 456 patients (24.3% ≥70 years) treated for CLM in a single center using Kaplan-Meier estimation of overall survival (OS), calculation of relative survival as estimate for disease-specific survival, and a Cox regression model.RESULTS:
Complete surgical resections were achieved more often in patients aged <70 years (39.2 vs. 28.1%, P = 0.056), and young patients more frequently received irinotecan or platin-based chemotherapies (70.3 vs. 41.6%, P < 0.001). Three-year OS and relative survival of patients ≥70 years were significantly lower compared to younger patients (OS 34.3 vs. 43.5%, P = 0.0114). In a Cox regression model, complete surgical removal of liver metastases was the most effective treatment (HR 0.313, P < 0.001) followed by chemotherapy (irinotecan/platin-based HR 0.371, 5-FU only HR 0.673, P < 0.001). Having >5 liver metastases, the presence of extrahepatic metastases, high grading, and a nodal positive primary but not age ≥70 years were associated with an increased risk of death.CONCLUSIONS:
Our data support radical resection and highly effective chemotherapy in selected elderly patients with CLM.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Neoplasias Hepáticas
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Neoplasias Primárias Múltiplas
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Langenbecks Arch Surg
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Alemanha