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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 8/2017

01-12-2017 | ORIGINAL ARTICLE

Synchronous colorectal liver metastases: focus on the elderly

An Effectiveness Study from Routine Care

Authors: Markus Albertsmeier, Andrea Engel, Markus O. Guba, Sebastian Stintzing, Tobias S. Schiergens, Gabriele Schubert-Fritschle, Dieter Hölzel, Jens Werner, Martin K. Angele, Jutta Engel

Published in: Langenbeck's Archives of Surgery | Issue 8/2017

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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.
Appendix
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Metadata
Title
Synchronous colorectal liver metastases: focus on the elderly
An Effectiveness Study from Routine Care
Authors
Markus Albertsmeier
Andrea Engel
Markus O. Guba
Sebastian Stintzing
Tobias S. Schiergens
Gabriele Schubert-Fritschle
Dieter Hölzel
Jens Werner
Martin K. Angele
Jutta Engel
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 8/2017
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-017-1611-8

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