학술논문
Resectability, Resections, Survival Outcomes, and Quality of Life in Older Adult Patients with Metastatic Colorectal Cancer (the RAXO-Study)
Document Type
article
Author
Kaisa Lehtomäki; Leena-Maija Soveri; Emerik Osterlund; Annamarja Lamminmäki; Aki Uutela; Eetu Heervä; Päivi Halonen; Hanna Stedt; Sonja Aho; Timo Muhonen; Annika Ålgars; Tapio Salminen; Raija Kallio; Arno Nordin; Laura Aroviita; Paul Nyandoto; Juha Kononen; Bengt Glimelius; Raija Ristamäki; Helena Isoniemi; Pia Osterlund
Source
Journal of Clinical Medicine, Vol 12, Iss 10, p 3541 (2023)
Subject
Language
English
ISSN
2077-0383
Abstract
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 (p < 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.