بيانات النشر: Uppsala universitet, Cancerprecisionsmedicin
Uppsala universitet, Science for Life Laboratory, SciLifeLab
Tampere Univ, Fac Med & Hlth Technol, Arvo Ylpon Katu 34, Tampere 33520, Finland.;Tampere Univ Hosp, Tays Canc Ctr, Dept Oncol, Teiskontie 35, Tampere 33520, Finland.
Helsinki Univ Hosp, Comprehens Canc Ctr, Dept Oncol, Helsinki 00290, Finland.;Univ Helsinki, Dept Oncol, Clin, Helsinki 00014, Finland.;Joint Municipal Author Hlth Care & Social Serv Ke, Home Care, Hyvinkaa 05850, Finland.
Helsinki Univ Hosp, Abdominal Ctr, Transplantat & Liver Surg, Helsinki 00290, Finland.;Uppsala Univ, Dept Immunol Genet & Pathol, S-75185 Uppsala, Sweden.
Kuopio Univ Hosp, Dept Oncol, Puijonlaaksontie 2, Kuopio 70210, Finland.;Univ Eastern Finland, Fac Hlth Sci, Yliopistonranta 1A, Kuopio 70210, Finland.
Helsinki Univ Hosp, Abdominal Ctr, Transplantat & Liver Surg, Helsinki 00290, Finland.;Univ Helsinki, Dept Surg, Clin, Helsinki 00014, Finland.
Turku Univ Hosp, Dept Oncol, Hameentie 11, Turku 20520, Finland.;Univ Turku, Dept Oncol, Kiinanmyllynkatu 10, Turku 20520, Finland.
Helsinki Univ Hosp, Comprehens Canc Ctr, Dept Oncol, Helsinki 00290, Finland.;Univ Helsinki, Dept Oncol, Clin, Helsinki 00014, Finland.
South Carel Cent Hosp, Dept Oncol, Valto Kakelan Katu 1, Lappeenranta 53130, Finland.
Oulu Univ Hosp, Dept Oncol, Kajaanintie 50, Oulu 90220, Finland.
Kanta Hame Cent Hosp, Dept Oncol, Ahvenistontie 20, Hameenlinna 13530, Finland.
Paijat Hame Cent Hosp, Dept Oncol, Keskussairaalankatu 7, Lahti 15850, Finland.
Docrates Hosp, Docrates Canc Ctr, Saukonpaadenranta 2, Helsinki 00180, Finland.;Cent Finland Cent Hosp, Dept Oncol, Keskussairaalantie 19, Jyvaskyla 40620, Finland.
Uppsala Univ, Dept Immunol Genet & Pathol, S-75185 Uppsala, Sweden.
Tampere Univ, Fac Med & Hlth Technol, Arvo Ylpon Katu 34, Tampere 33520, Finland.;Tampere Univ Hosp, Tays Canc Ctr, Dept Oncol, Teiskontie 35, Tampere 33520, Finland.;Helsinki Univ Hosp, Comprehens Canc Ctr, Dept Oncol, Helsinki 00290, Finland.;Univ Helsinki, Dept Oncol, Clin, Helsinki 00014, Finland.;Karolinska Univ Sjukhuset, Dept Gastrointestinal Oncol, Tema Canc, Eugeniavagen 3, S-17176 Solna, Sweden.;Karolinska Inst, Dept Oncol Pathol, Solnavagen 1, S-17177 Solna, Sweden.
MDPI
نبذة مختصرة : 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 (<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 (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.
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