Abstract 514P
Background
Surgery is the only potentially curative option for CRLM if resectable. Curative approach in patients over 70 years old is challenging mainly because of comorbidities and other geriatric syndromes. Herein, we report an updated analysis of elderly patients with resectable CRLM in our center. In addition, we intended to evaluate the prognostic value of neutrophil to lymphocyte ratio (NLR) in these patients.
Methods
Outcomes of patient operated at Centre Hospitalier de l’Université de Monréal (CHUM) between 2010 and 2016 were previously reported. Updated database of elderly patients operated between 2016 and 2019 were retrospectively analyzed. A cut-off value of 3 was adopted to discriminate pts with low (NLR<3) versus high (NLR≥3) NLR. The Kaplan-Meier method was used to estimate survival.
Results
From 2010 to 2019, 210 patients older than 70 years were identified. Median age was 76 years. CRLM were synchronous in 56%. 85% of patients had at least 2 or more comorbidities. Median relapse free survival (mRFS) of patients ≥ 70 years was 41.3 months. Median OS was 62.2 months and estimated 5-year survival was 51.5% similar to those of less than 70 years old. Patients with high NLR had shorter progression-free survival (PFS) and overall survival (OS) than patients with low NLR (PFS: 36 vs 76 months; p=0.07 and OS: 58.7 vs not reached; p=0.09). Although non-statistically significant, Patients with metachronous CRLM had superior mOS compared to those with synchronous disease (67.2 vs 58.7 months; p=0.42) and median OS was significantly shorter in patients with right colon primaries compared to those of left colon (46.8 vs 67.2 months; p=0.17).
Conclusions
In our updated cohort, survival outcomes of patients with an age ≥ 70 years were comparable to those of younger patients and what is reported in literature. Age should not be a limiting factor in the curative management of elderly patients with resectable CRLM. NLR as a prognostic factor and its role in clinical practice are yet to be defined.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.