TY - JOUR
T1 - Onco-surgical management of colo-rectal liver metastases in older patients
T2 - A new frontier in the 3rd millennium
AU - Di Benedetto, Fabrizio
AU - D'Amico, Giuseppe
AU - Spaggiari, Mario
AU - Tirelli, Umberto
AU - Berretta, Massimiliano
PY - 2013
Y1 - 2013
N2 - Colorectal cancer (CRC) is one the most common malignant tumors in industrialized countries today. Over half of all cancers are currently diagnosed in elderly patients, and 76% of all colorectal cancer patients are diagnosed between 65 and 85 years old. Elderly patients are less likely to undergo curative surgery, and less likely to be offered the option of metastasectomy when colorectal liver metastases (CLM) are present. Hepatic resection has become the standard care for the treatment of isolated CLM. However, in studies reporting resection of CLM only 8-20% of the patients are older than 70 years. When balancing the benefits of surgical resection of liver metastases against the potential risks of surgery, many clinicians are still reluctant to advise in favor of surgical treatment in the elderly. Factors other than age should also be considered when evaluating surgical risk in the elderly, for example, conditions such as heart disease and diabetes have been shown to induce life-threatening postoperative complications. Age alone need not be a contraindication to aggressive surgical therapy in this group, rather, appropriate selection criteria based on tumor characteristics and general medical fitness, similar to those used for younger patients, should be applied.
AB - Colorectal cancer (CRC) is one the most common malignant tumors in industrialized countries today. Over half of all cancers are currently diagnosed in elderly patients, and 76% of all colorectal cancer patients are diagnosed between 65 and 85 years old. Elderly patients are less likely to undergo curative surgery, and less likely to be offered the option of metastasectomy when colorectal liver metastases (CLM) are present. Hepatic resection has become the standard care for the treatment of isolated CLM. However, in studies reporting resection of CLM only 8-20% of the patients are older than 70 years. When balancing the benefits of surgical resection of liver metastases against the potential risks of surgery, many clinicians are still reluctant to advise in favor of surgical treatment in the elderly. Factors other than age should also be considered when evaluating surgical risk in the elderly, for example, conditions such as heart disease and diabetes have been shown to induce life-threatening postoperative complications. Age alone need not be a contraindication to aggressive surgical therapy in this group, rather, appropriate selection criteria based on tumor characteristics and general medical fitness, similar to those used for younger patients, should be applied.
KW - Colorectal liver metastases
KW - Elderly patients
KW - Morbility and mortality
KW - Onco-surgical management
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U2 - 10.2174/18715206113136660344
DO - 10.2174/18715206113136660344
M3 - Article
C2 - 24102282
AN - SCOPUS:84888229241
SN - 1871-5206
VL - 13
SP - 1354
EP - 1363
JO - Anti-Cancer Agents in Medicinal Chemistry
JF - Anti-Cancer Agents in Medicinal Chemistry
IS - 9
ER -