Management of Colorectal Cancer Liver Metastases in The Elderly_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIA Changjun , DAI Chaoliu.

Hepatobiliary and Splenic Surgery Ward of Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China;

Corresponding author：

Keywords：

Gerontism; Colorectal cancer; Liver metastasis; Management

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ObjectiveTo summarize the current status and the management of colorectal cancer liver metastases (CRCLM) in the elderly and to explore the therapeutic principles and methods. MethodsForeign and domestic literatrues on management of CRCLM were reviewed and analyzed. ResultsColorectal cancer was still one of the most common malignancy and the most common site for metastasis was liver. In the past years, the incidence of colorectal cancer in the elderly was gradually going up. A similar outcome can be achieved for the appropriate elder metastasis patients compared to the young group, although they were in worse physical conditions. Surgical resection was still the only possible treatment for cure to the resectable CRCLM, chemotherapy and biological therapy were also valuable adjunct therapies. For unresectable liver metastases, alternative treatments were recommended, such as radiofrequency ablation and hepatic artery infusion, etc. ConclusionAccording to the characteristic of CRCLM and the physical features of the eldrly patients, a better outcome should be obtained through multipledisciplinary individualized therapy.

Citation： JIA Changjun,DAI Chaoliu.. Management of Colorectal Cancer Liver Metastases in The Elderly. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 485-493. doi: Copy

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16. Brand MI, Saclarides TJ, Dobson HD, et al. Liver resection for colorectal cancer: liver metastases in the aged [J]. Ann Surg, 2000, 66(4): 412415， discussion 415416.
17. Zacharias T, Jaeck D, Oussoultzoglou E, et al. First and repeat resection of colorectal liver metastases in elderly patients [J]. Ann Surg, 2004, 240(5): 858865.
18. Nagano Y, Nojiri K, Matsuo K, et al. The impact of advanced age on hepatic resection of colorectal liver metastases [J]. J Am Coll surg, 2005, 201(4): 511516.
19. Menon KV, AlMukhtar A, Aldouri A, et al. Outcomes after major hepatectomy in elderly patients [J]. J Am Coll Surg, 2006, 203(5): 677683.
20. Figueras J, Ramos E, LopezBen S, et al. Surgical treatment of liver metastases from colorectal carcinoma in elderly patients. When is it worthwhile? [J]. Clin Transl Oncol, 2007, 9(6): 392400.
21. Mazzoni G, Tocchi A, Miccini M, et al. Surgical treatment of liver metastases from colorectal cancer in elderly patients [J]. Int J Colorectal Dis, 2007, 22(1): 7783.
22. Wang X, Hershman DL, Abrams JA, et al. Predictors of survival after hepatic resection among patients with colorectal liver metastasis [J]. Br J Cancer, 2007, 97(12): 16061612.
23. de LiguoriCarino N, van Leeuwen BL, Ghaneh P, et al. Liver resection for colorectal liver metastases in older patients [J]. Crit Rev Oncol Hematol, 2008, 67(3): 273278.
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25. Bockhorn M, Sotiropoulos GC, Sgourakis G, et al. Major liver resections in the elderly-is an aggressive approach justified? [J]. Int J Colorectal Dis, 2009, 24(1): 8386.
26. Nojiri K, Nagano Y, Tanaka K, et al. Validity of hepatic resection of colorectal liver metastases in the elderly (75 years and older) [J]. Anticancer Res, 2009, 29(2): 583588.
27. Tamandl D, Gruenberger B, Herberger B, et al. Surgery after neoadjuvant chemotherapy for colorectal liver metastases is safe and feasible in elderly patients [J]. J Surg Oncol, 2009, 100(5): 364371.
28. Robertson DJ, Stukel TA, Gottlieb DJ, et al. Survival after hepatic resection of colorectal cancer metastases: a national experience [J]. Cancer, 2009, 15(4): 752759.
29. Rees M, Tekkis PP, Welsh FK, et al. Evaluation of longterm survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients [J]. Ann Surg, 2008, 247(1): 125135.
30. Reddy SK, Barbas AS, Turley RS, et al. Major liver resection in elderly patients: a multiinstitutional analysis [J]. J Am Coll Surg, 2011, 212(5): 787795.
31. 蔡三军. 结直肠癌肝转移的治疗现状 [J]. 中华胃肠外科杂志, 2009, 12(4): 430431.
32. Thelen A, Jonas S, Benckert C, et al. Simultaneous versus staged liver resection onf synchronous liver metastasis from colorectal cancer [J]. Int J Colorectal Dis, 2007, 22(10): 12691276.
33. 涂玉亮, 焦华波, 谭向东, 等. 70岁以上老年患者结直肠癌肝转移同步手术切除的临床分析 [J]. 中国急救复苏与灾害医学杂志, 2010, 5(8): 734736, 744.
34. Brouquet A, Abdalla EK, Kopetz S, et al. High survival rate after twostage resection of advanced colorectal liver metastases: responsebased selection and complete resection define outcome [J]. J Clin Oncol, 2011, 29(8): 10831090.
35. Wicherts DA, Miller R, de Haas RJ, et al. Longterm results of twostage hepatectomy for irresectable colorectal cancer liver metastases [J]. Ann Surg, 2008, 248(6): 9941005.
36. Karoui M, Viqano L, Goyer P, et al. Combined firststage hepatectomy and colorectal resection in a twostage hepatectomy strategy for bilobar synchronous liver metastases [J]. Br J Surg, 2010， 97(9): 13541362.
37. Mohammad WM, Balaa FK. Surgical management of colorectal liver metastases [J]. Clin Colon Rectal Surg, 2009, 22(4): 225232.
38. de Jong MC, Mayo SC, Pulitano C, et al. Repeat curative intent liver surgery is safe and effective for recurrent colorectal liver metastases: results from an international multiinstitutional analysis [J]. J Gastrointest Surg, 2009, 13(12): 21412151.
39. Sa Cunha A, Laurent C, Rault A, et al. A second liver resection due to recurrent colorectal liver metastases [J]. Arch Surg, 2007, 142(12): 11441149.
40. de Liquori Carino N, van Leeuwen BL, Ghaneh P, et al. Liver resection for colorectal liver metastases in older patients [J]. Crit Rev Oncol Hematol, 2008, 67(3): 273278.
41. Adam R, Bhanqui P, Poston G, et al. Is perioperative chemotherapy useful for solitary, metachronous, colorectal liver metastases? [J]. Ann Surg, 2010, 252(5): 774787.
42. Nordlinger B, Van Cutsem E, Rouqier P, et al. Does chemotherapy prior to liver resection increase the potential for cure in patients with metastatic colorectal cancer? A report from the European Colorectal Metastases Treatment Group [J]. Eur J Cancer, 2007, 43(14): 20372045.
43. Poultsides GA, Servais EL, Saltz LB, et al. Outcome of primary tumor in patients with synchronous stage Ⅳ colorectal cancer receiving combination chemotherapy without surgery as initial treatment [J]. J Clin Oncol, 2009, 27(20): 33793384.
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45. Costi R, Di Mauro D, Veronesi L, et al. Elective palliative resection of incurable stage Ⅳ colorectal cancer: who really benefits from it? [J]. Surg Today, 2011, 41(2): 222229.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Management of Colorectal Cancer Liver Metastases in The Elderly

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