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 Detalle_Publicacion

Liver resection in elderly patients with extensive CRLM: are we offering an adequate treatment? A propensity score matched analysis

Abstract: Background: Data on the management of elderly patients with extensive colorectal liver metastases (CRLM) are scarce and conflicting. This study assesses differences in management and long-term oncological outcomes between older and younger patients with CRLM and a high Tumour Burden Score (TBS). Methods: International multicentre retrospective study on patients with CRLM and a category 3 TBS, submitted to liver resection. Patients were divided into two groups according to their age (younger and older than 75) and were compared using propensity score matching (PSM) analysis and multivariable regression models. Differences in management and oncological outcomes including recurrence-free survival (RFS) and overall survival (OS) were assessed. Results: The study included 386 patients, median follow-up was 48 months. The unmatched comparison revealed a higher ASA score (p = 0.035), less synchronous CRLM (47% vs 68%, p = 0.003), a lower median number of lesions (1 vs 3, p = 0.004) and less perioperative chemotherapy (CTx) (66% vs 88%, p < 0.001) in the elderly group. Despite the absence of CTx being an independent predictor of decreased RFS and OS (HR 0.760, p = 0.044 and HR 0.719, p = 0.049, respectively), the elderly group still received less CTx (OR 0.317, p = 0.001) than the younger group. After PSM (n = 100 patients), the two groups were comparable, however, CTx administration was still significantly lower in the elderly group. Conclusion: Liver resection should be considered in patients aged 75 and older, even if they present with extensive liver disease. Despite CTx being associated with improved oncological outcomes, a large percentage of elderly patients with CRLM are undertreated.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: European Journal of Surgical Oncology, 2022, 48 (6), 1331-1338

Editorial: Elsevier

 Año de publicación: 2022

Nº de páginas: 8

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ejso.2021.12.028

ISSN: 0748-7983,1532-2157

Url de la publicación: https://doi.org/10.1016/j.ejso.2021.12.028

Autores/as

DI MARTINO, MARCELLO

DORCARATTO, DIMITRI

PRIMAVESI, FLORIAN

SYN, NICHOLAS

BLANCO-TERÉS, LARA

DUPRÉ, AURÉLIEN

PIARDI, TULLIO

RHAIEM, RAMI

FERNÁNDEZ, GERARDO BLANCO

DE ARMAS CONDE, NOELIA

SANTIAGO, ROBERTO FERNÁNDEZ

FERNÁNDEZ-MORENO, MARÍA-CARMEN

FERRET, GEORGINA

BEN, SANTIAGO LÓPEZ

SUÁREZ MUÑOZ, MIGUEL ÁNGEL

PEREZ-ALONSO, ALEJANDRO J

KOH, YE-XIN

JONES, ROBERT

VENNARECCI, GIOVANNI