Outcomes of elderly patients with resectable liver metastases from colorectal cancer (CRLM): Single center experience.
Bibliographic record
Abstract
34 Background: Half of patients with colorectal cancer develop liver metastases during the course of their disease. Surgery is the only potentially curative option for CRLM if resectable. Treatment of patients over 70 years old is challenging mainly because of comorbidities and other geriatric syndromes. Thus, we intended to report our experience with elderly patients with resectable CRLM. Methods: After approval by the Institutional Review Board (IRB), all records from a prospectively collected database at Centre Hospitalier de l’Université de Monréal (CHUM) were retrospectively analyzed. Clinicopathological characteristics, surgery and chemotherapy treatment modalities were reviewed. RFS and OS in patients ≥ 70y were calculated using the Kaplan Meier survival curve. Results: From 2010 to 2016, 101 patients older than 70 years were identified. Safety and surgical complications were previously reported. Median age was 75 years. CRLM were synchronous in 46.5% and metachronous in 53.5%. Relapse free survival (RFS) of patients ≥ 70 years was 33.7 months. Overall survival (OS) of patients ≥70 years was comparable to those of less than 65 years old (median OS: 56 vs 62 months; p = 0.15, respectively). Hepatic relapse showed worse survival when compared to extra-liver recurrence, mOS: 44 vs 33.2 vs 29.3 months for non-hepatic, hepatic only and hepatic with other sites respectively (trend p = 0.034). Although non-statistically significant, Patients with metachronous CRLM had superior mOS compared to those with synchronous disease (58.7 vs 44.7 months; p = 0.22). Conclusions: 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 management of elderly patients with resectable CRLM. Hepatic metastatectomies +/- chemotherapy should be offered with curative intents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".