Critical Reviews in Oncology / Hematology
Volume 77, Issue 2 , Pages 100-108, February 2011

Global graying, colorectal cancer and liver metastasis: New implications for surgical management

  • Daniel A. Anaya

      Affiliations

    • Department of Surgery – Surgical Oncology, Michael E. DeBakey VA Medical Center, Houston, TX, United States
    • Houston Center for Quality of Care & Utilization Studies, United States
    • Baylor College of Medicine, Houston, TX, United States
    • Corresponding Author InformationCorresponding author at: Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, OCL (112), Houston, TX 77030, United States. Tel.: +1 713 794 8026; fax: +1 713 794 7352.
  • ,
  • Natasha S. Becker

      Affiliations

    • Department of Surgery – Surgical Oncology, Michael E. DeBakey VA Medical Center, Houston, TX, United States
    • Baylor College of Medicine, Houston, TX, United States
  • ,
  • Neena S. Abraham

      Affiliations

    • Houston Center for Quality of Care & Utilization Studies, United States
    • Gastroenterology Outcomes in Geriatrics (GO-GERI) Unit, United States
    • Department of Medicine, Gastroenterology at the Michael E. DeBakey VA Medical Center, Houston, TX, United States
    • Baylor College of Medicine, Houston, TX, United States

Accepted 5 February 2010. published online 08 March 2010.

Abstract 

Aging of the population – global graying – is occurring rapidly, with significant effects on epidemiology, treatment and outcomes for cancer patients. In colorectal cancer, outcomes for the elderly are worse than those for younger patients, partially driven by treatment disparities between the two groups. Nonetheless, standard-of-care treatment for the elderly results in equivalent long-term outcomes to those observed in the younger population; and available data support the use of aggressive surgery and adjuvant therapies in well-selected patients. Data evaluating epidemiology, treatment patterns and outcomes in elderly patients with colorectal cancer liver metastasis are lacking. Liver resection offers the only curative approach, but it is rarely offered to older adults. Current data support the use of hepatectomy for well-selected elderly colorectal cancer patients with liver metastasis; however, this and other evolving therapies need to be assessed in the elderly to better define their role, indications, safety and outcomes.

Keywords: Colorectal neoplasm, Metastasis, Liver neoplasm, Population dynamics, Aging

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PII: S1040-8428(10)00033-8

doi:10.1016/j.critrevonc.2010.02.003

Critical Reviews in Oncology / Hematology
Volume 77, Issue 2 , Pages 100-108, February 2011