Department of Medicine, Hematology-Oncology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC H2X 0C1, Canada.
Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC H2X 0A9, Canada.
Curr Oncol. 2021 May 18;28(3):1899-1908. doi: 10.3390/curroncol28030176.
Surgery is the only potential curative option of CRLM if resectable. The curative approach in patients over 70 years old is challenging mainly because of comorbidities and other geriatric syndromes. Herein, we report outcomes of older patients with resectable CRLM in our center. We retrospectively analyzed characteristics and outcomes of older patients with CRLM operated at "Centre Hospitalier de l'Université de Montréal" (CHUM) between 2010 and 2019. We identified 210 patients aged ≥70 years with a median age of 76 (range: 70-85). CRLM were synchronous in 56% of patients. Median disease-free survival (DFS) was 41.3 months. Median overall survival (OS) was 62.2 months and estimated 5-year survival rate was 51.5% similar to those of younger counterparts. Patients with metachronous CRLM had a trend to a higher OS compared to those with synchronous disease (67.2 vs. 58.7 months; = 0.42). Factors associated with lower survival in the multivariate analysis were right-sided tumors and increased Charlson Comorbidity index (CCI). Survival outcomes of patients aged ≥70 years were comparable to those of younger patients and those reported in the literature. Age should not be a limiting factor in the curative management of older patients with resectable CRLM.
如果可切除,手术是结直肠癌肝转移(CRLM)的唯一潜在治愈选择。70 岁以上患者的治愈方法具有挑战性,主要是因为合并症和其他老年综合征。在此,我们报告了我们中心可切除 CRLM 老年患者的结局。我们回顾性分析了 2010 年至 2019 年在“蒙特利尔大学医疗中心(CHUM)”接受手术的 CRLM 老年患者的特征和结局。我们确定了 210 名年龄≥70 岁的患者,中位年龄为 76 岁(范围:70-85 岁)。56%的患者为同步 CRLM。无病生存(DFS)的中位时间为 41.3 个月。总生存(OS)的中位时间为 62.2 个月,估计 5 年生存率为 51.5%,与年轻患者相似。与同步疾病相比,具有异时性 CRLM 的患者具有更高的 OS 趋势(67.2 与 58.7 个月; = 0.42)。多变量分析中与生存率降低相关的因素是右侧肿瘤和增加的 Charlson 合并症指数(CCI)。≥70 岁患者的生存结局与年轻患者和文献报道的结果相当。年龄不应成为可切除 CRLM 老年患者治愈治疗的限制因素。