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Liver Resection for Colorectal Metastases: Is There an Age Limit? The Japanese Perspective

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Current Colorectal Cancer Reports

Abstract

Liver resection is the only cure-oriented strategy for colorectal liver metastases, even in elderly patients. In the literature, there are no significant differences in overall survival and disease-free survivals between the elderly and the younger patients, who underwent liver resection, immediately or after preoperative chemotherapy. Morbidity and mortality rates are slightly increased in the elderly. Careful preoperative evaluation and postoperative monitoring is essential to improve patients’ survival. Patient selection should be discussed on a case-by-case basis by a multidisciplinary team. Older age is not a contraindication for liver resection.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Ferlay J, Shin H-R, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–917. This article is the latest worldwide cancer statistics by IARC.

    Article  PubMed  CAS  Google Scholar 

  2. CANCER STATISTICS in JAPAN ‘09 Available at http://ganjoho.jp/public/statistics/backnumber/2010_jp.html.

  3. Folprecht G, Gruenberger T, Bechstein BO, et al. Tumor response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: thr CELIM randomised phase 2 trial. Lancet Oncol. 2010;11:38–47.

    Article  PubMed  CAS  Google Scholar 

  4. Falcone A, Ricci S, Brunetti I, et al. Phase III trial of Infusional Fluorouracil, Leucovorin, Oxaliplatin, and Irinotecan (FOLFOXIRI) Compared With Infusional Fluorouracil, Leucovorin, and Irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol. 2007;25:1670–6.

    Article  PubMed  CAS  Google Scholar 

  5. Nordinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.

    Article  Google Scholar 

  6. Japanese Society for Cancer of the Colon and Rectum. Japanese classification of colorectal carcinoma, Second English Edition. Tokyo: Kanehara & Co., Ltd; 2009.

    Google Scholar 

  7. Kanemitsu Y, Kato T, Shimizu Y, et al. A randomized phase II/III trial comparing hepatectomy followed by mFOLFOX6 with hepatectomy alone as treatment for liver metastasis from colorectal cancer: Japan Clinical Oncology Group Study JCOG0603. Jpn J Clin Oncol. 2009;39(6):406–9.

    Article  PubMed  Google Scholar 

  8. Colorectal Cancer Collaborative Group. Surgery for colorectal cancer in elderly patients: a systematic review. Lancet. 2000;356:968–74.

    Article  Google Scholar 

  9. •• Pallis AG, Papamichael D, Audisio R, et al. EORTC Elderly Task Force experts’ opinion for the treatment of colon cancer in older patients. Cancer Treat Rev. 2010;36:83–90. This article is a recent taskforce report of treatments for elderly colorectal cancer patients from the EORTC.

    Article  PubMed  CAS  Google Scholar 

  10. Zacharias T, Jaeck D, Oussoultzoglou E, et al. First and repeat resection of colorectal liver metastases in elderly patients. Ann Surg. 2004;240(5):858–65.

    Article  PubMed  Google Scholar 

  11. Mazzoni G, Tocchi A, Miccini M, et al. Surgical treatment of liver metastases from colorectal cancer in elderly patients. Int J Colorectal Dis. 2007;22(1):77–83.

    Article  PubMed  Google Scholar 

  12. Mann CD, Neal CP, Pattenden CJ, et al. Major resection of hepatic colorectal liver metastases in elderly patients – an aggressive approach is justified. Eur J Surg Oncol. 2008;34(4):428–32.

    PubMed  CAS  Google Scholar 

  13. Bockhorn M, Sotiropoulos GC, Sgourakis G, et al. Major liver resections in the elderly—is an aggressive approach justified? Int J Colorectal Dis. 2009;24(1):83–6.

    Article  PubMed  Google Scholar 

  14. de Liguori-Carino N, van Leeuwen BL, Ghaneh P, et al. Liver resection for colorectal liver metastases in older patients. Crit Rev Oncol Hematol. 2008;67(3):273–8.

    Article  PubMed  Google Scholar 

  15. Alberts SR, Horvath WL, Sternfeld WC, et al. Oxaliplatin, Fluorouracil, and Leucovorin for Patients With Unresectable Liver-Only Metastases From Colorectal Cancer: A North Central Cancer Treatment Group Phase II Study. J Clin Oncol. 2005;23:9243–9.

    Article  PubMed  CAS  Google Scholar 

  16. Skof E, Rebersek M, Hlebanja Z, et al. Capecitabine plus Irinotecan (XELIRI regimen) compared to 5-FU/LV plus Irinotecan (FOLFIRI regimen) as neoadjuvant treatment for patients with unresectable liver-only metastases of metastatic colorectal cancer: a randomised prospective phase II trial. BMC Cancer. 2009;9:120.

    Article  PubMed  Google Scholar 

  17. Coskun U, Buyukberber S, Yaman E, et al. Xelox (capecitabine plus oxaliplatin) as neoadjuvant chemotherapy of unresectable liver metastases in colorectal cancer patients. Neoplasma. 2008;55(1):65–70.

    PubMed  CAS  Google Scholar 

  18. Van Cutsem E, Rivera F, Berry S, et al. Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol. 2009;20(11):1842–7.

    Article  PubMed  Google Scholar 

  19. Min BS, Kim NK, Ahn JB, et al. Cetuximab in combination with 5-fluorouracil, leucovorin and irinotecan as a neoadjuvant chemotherapy in patients with initially unresectable colorectal liver metastases. Onkologie. 2007;30(12):637–43.

    Article  PubMed  CAS  Google Scholar 

  20. Sanoff HK, Bleiberg H, Goldberg RM. Managing older patients with colorectal cancer. J Clin Oncol. 2007;25(14):1891–7.

    Article  PubMed  Google Scholar 

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Correspondence to Yasuhiro Shimada.

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Shimada, Y. Liver Resection for Colorectal Metastases: Is There an Age Limit? The Japanese Perspective. Curr Colorectal Cancer Rep 7, 187–190 (2011). https://doi.org/10.1007/s11888-011-0095-0

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