Resectability, Resections, Survival Outcomes, and Quality of Life in Older Adult Patients with Metastatic Colorectal Cancer (the RAXO-Study)
Older adults are underrepresented in metastatic colorectal cancer (mCRC) studies and thus may not receive optimal treatment, especially not metastasectomies. The prospective Finnish real-life RAXO-study included 1086 any organ mCRC patients. We assessed repeated centralized resectability, overall su...
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| creator | Lehtomäki, Kaisa Soveri, Leena-Maija Osterlund, Emerik Lamminmäki, Annamarja Uutela, Aki Heervä, Eetu Halonen, Päivi Stedt, Hanna Aho, Sonja Muhonen, Timo Ålgars, Annika Salminen, Tapio Kallio, Raija Nordin, Arno Aroviita, Laura Nyandoto, Paul Kononen, Juha Glimelius, Bengt Ristamäki, Raija Isoniemi, Helena Osterlund, Pia |
| description | Older adults are underrepresented in metastatic colorectal cancer (mCRC) studies and thus may not receive optimal treatment, especially not metastasectomies. The prospective Finnish real-life RAXO-study included 1086 any organ mCRC patients. We assessed repeated centralized resectability, overall survival (OS), and quality of life (QoL) using 15D and EORTC QLQ-C30/CR29. Older adults (>75 years; n = 181, 17%) had worse ECOG performance status than adults ( |
| doi_str_mv | 10.3390/jcm12103541 |
| format | Article |
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< 0.001). The older adults compared with adults were less likely to undergo curative-intent R0/1-resection (19% vs. 32%), but when resection was achieved, OS was not significantly different (HR 1.54 [CI 95% 0.9-2.6]; 5-year OS-rate 58% vs. 67%). 'Systemic therapy only' patients had no age-related survival differences. QoL was similar in older adults and adults during curative treatment phase (15D 0.882-0.959/0.872-0.907 [scale 0-1]; GHS 62-94/68-79 [scale 0-100], respectively). Complete curative-intent resection of mCRC leads to excellent survival and QoL even in older adults. Older adults with mCRC should be actively evaluated by a specialized MDT and offered surgical or local ablative treatment whenever possible.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12103541</identifier><identifier>PMID: 37240646</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Ablation (Surgery) ; Age ; Aged patients ; Cancer therapies ; Care and treatment ; Clinical medicine ; Colorectal cancer ; Confidence intervals ; cytoreductive surgery ; Decision making ; Development and progression ; Diagnosis ; Health aspects ; health-related quality of life ; Hospitals ; Liver ; liver resection ; local ablative therapy ; lung resection ; Medicin och hälsovetenskap ; metastasectomy ; Metastasis ; metastatic colorectal cancer ; older adults ; Older people ; oncological treatment ; Patient outcomes ; Patients ; Quality of life ; Questionnaires ; Remission (Medicine) ; Surgeons ; Tomography</subject><ispartof>JOURNAL OF CLINICAL MEDICINE, 2023-05, Vol.12 (10), p.3541</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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The prospective Finnish real-life RAXO-study included 1086 any organ mCRC patients. We assessed repeated centralized resectability, overall survival (OS), and quality of life (QoL) using 15D and EORTC QLQ-C30/CR29. Older adults (>75 years; n = 181, 17%) had worse ECOG performance status than adults (<75 years, n = 905, 83%), and their metastases were less likely upfront resectable. The local hospitals underestimated resectability in 48% of older adults and in 34% of adults compared with the centralized multidisciplinary team (MDT) evaluation (
< 0.001). The older adults compared with adults were less likely to undergo curative-intent R0/1-resection (19% vs. 32%), but when resection was achieved, OS was not significantly different (HR 1.54 [CI 95% 0.9-2.6]; 5-year OS-rate 58% vs. 67%). 'Systemic therapy only' patients had no age-related survival differences. QoL was similar in older adults and adults during curative treatment phase (15D 0.882-0.959/0.872-0.907 [scale 0-1]; GHS 62-94/68-79 [scale 0-100], respectively). Complete curative-intent resection of mCRC leads to excellent survival and QoL even in older adults. Older adults with mCRC should be actively evaluated by a specialized MDT and offered surgical or local ablative treatment whenever possible.</description><subject>Ablation (Surgery)</subject><subject>Age</subject><subject>Aged patients</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Colorectal cancer</subject><subject>Confidence intervals</subject><subject>cytoreductive surgery</subject><subject>Decision making</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Health aspects</subject><subject>health-related quality of life</subject><subject>Hospitals</subject><subject>Liver</subject><subject>liver resection</subject><subject>local ablative therapy</subject><subject>lung resection</subject><subject>Medicin och hälsovetenskap</subject><subject>metastasectomy</subject><subject>Metastasis</subject><subject>metastatic colorectal cancer</subject><subject>older 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< 0.001). The older adults compared with adults were less likely to undergo curative-intent R0/1-resection (19% vs. 32%), but when resection was achieved, OS was not significantly different (HR 1.54 [CI 95% 0.9-2.6]; 5-year OS-rate 58% vs. 67%). 'Systemic therapy only' patients had no age-related survival differences. QoL was similar in older adults and adults during curative treatment phase (15D 0.882-0.959/0.872-0.907 [scale 0-1]; GHS 62-94/68-79 [scale 0-100], respectively). Complete curative-intent resection of mCRC leads to excellent survival and QoL even in older adults. Older adults with mCRC should be actively evaluated by a specialized MDT and offered surgical or local ablative treatment whenever possible.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>37240646</pmid><doi>10.3390/jcm12103541</doi><orcidid>https://orcid.org/0000-0002-7124-3515</orcidid><orcidid>https://orcid.org/0000-0002-5440-791X</orcidid><orcidid>https://orcid.org/0000-0003-1324-5894</orcidid><orcidid>https://orcid.org/0000-0002-2994-1459</orcidid><orcidid>https://orcid.org/0000-0002-3065-0763</orcidid><orcidid>https://orcid.org/0000-0002-9760-0840</orcidid><orcidid>https://orcid.org/0000-0003-0973-6332</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | PubMed Central Free; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute |
| subjects | Ablation (Surgery) Age Aged patients Cancer therapies Care and treatment Clinical medicine Colorectal cancer Confidence intervals cytoreductive surgery Decision making Development and progression Diagnosis Health aspects health-related quality of life Hospitals Liver liver resection local ablative therapy lung resection Medicin och hälsovetenskap metastasectomy Metastasis metastatic colorectal cancer older adults Older people oncological treatment Patient outcomes Patients Quality of life Questionnaires Remission (Medicine) Surgeons Tomography |
| title | Resectability, Resections, Survival Outcomes, and Quality of Life in Older Adult Patients with Metastatic Colorectal Cancer (the RAXO-Study) |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T08%3A19%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Resectability,%20Resections,%20Survival%20Outcomes,%20and%20Quality%20of%20Life%20in%20Older%20Adult%20Patients%20with%20Metastatic%20Colorectal%20Cancer%20(the%20RAXO-Study)&rft.jtitle=JOURNAL%20OF%20CLINICAL%20MEDICINE&rft.au=Lehtom%C3%A4ki,%20Kaisa&rft.date=2023-05-18&rft.volume=12&rft.issue=10&rft.spage=3541&rft.pages=3541-&rft.issn=2077-0383&rft.eissn=2077-0383&rft_id=info:doi/10.3390/jcm12103541&rft_dat=%3Cgale_swepu%3EA752657834%3C/gale_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2819453478&rft_id=info:pmid/37240646&rft_galeid=A752657834&rfr_iscdi=true |