Management and Outcome of Colorectal Cancer Liver Metastases in Elderly Patients

Abstract

Resection of CRC LM is associated with greater risk of postoperative mortality among elderly patients despite less aggressive treatment. Although the long-term outcomes are inferior to younger patients, a substantial proportion of elderly patients will have long-term survival.

Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

“…Major hepatectomy was more frequently performed in patients aged <75 years (61%) compared with patients aged >75 years (53%; p  = 0.003). Only 2 studies reported histopathological radicality [28, 29], which showed no differences (90 vs. 89%; p  = 0.45; Table 4). …”

“…The increase in weighted postoperative morbidity and mortality for patients aged >75 years in this study supports this trend; the postoperative mortality almost doubles in patients >75 years. A dozen number of studies use even 65 years or even lesser as a cut-off point [46-49], but other studies select patients over 75 [50, 51] or even over 80 years of age [31, 39, 52]. …”

“…The included studies in this systematic review used different regimens of (neo)adjuvant chemotherapy [9, 10, 12, 22, 24-27, 29, 30] and several studies did not report on the administration of chemotherapy [19-21, 23, 28]. These differences, however, reflect variations in the stage of the disease and the differences between countries, which probably also adds to generalizability.…”

Radiosurgery for liver metastases. A single institution experience

“…This may avoid costly and/or prolonged chemotherapy regimens or other traditional alternatives that may have significant toxicity with lower quality of life. 21,22 …”

Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity.

“…Current literature regarding treatment decisions for elderly patients with CRC is conflicting. Alongside reports on the benefit of chemotherapy and surgery in elderly CRC patients [3138] , there are data implying a minimal benefit for oxaliplatin in the adjuvant setting [27,39] and a higher treatment complication rate [28,40] in older patients. In this cohort, there was no difference in chemotherapy associated toxicity.…”