Evidence map›Paper›PMID 32320417›Full record

SynthesisPloS one2020

Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis.

Nicola de'Angelis, Capucine Baldini, Raffaele Brustia, Patrick Pessaux, Daniele Sommacale, Alexis Laurent, Bertrand Le Roy, Vania Tacher, Hicham Kobeiter, Alain Luciani and 4 more

Erratum issuedAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Nicola de'AngelisUnit of Digestive, Hepato-Pancreato-Biliary Surgery, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.ORCID 0000-0002-1211-4916
Capucine BaldiniDrug Development Department, Gustave Roussy Cancer Campus, University Paris-Saclay, Villejuif, France.
Raffaele BrustiaDepartment of Hepato-biliary and Liver Transplantation Surgery, Pitié-Salpêtrière University Hospital, APHP, Paris, France.
Patrick PessauxDigestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, and U1110 Inserm, Institute of Viral and Liver Disease, Strasbourg, France.
Daniele SommacaleDepartment of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
Alexis LaurentUnit of Digestive, Hepato-Pancreato-Biliary Surgery, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Bertrand Le RoyDepartment of Digestive Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France.
Vania TacherDepartement of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Hicham KobeiterDepartement of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Alain LucianiDepartement of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Elena PaillaudHopital Europeen Georges Pompidou, Department of Geriatrics, Paris, France.
Thomas AparicioGastroenterology and Digestive Oncology Department, Saint Louis Hospital, AP-HP, and University of Paris, Paris, France.
Florence Canuï-PoitrineDepartment of Epidemiology and Biostatistics, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.
Evelyne LiuuDepartment of Geriatrics, CHU La Milétrie, Poitiers University Hospital, Grand Poitiers, France.ORCID 0000-0003-2758-5064

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe present study explored the existing literature to describe the outcomes of surgical and regional treatments for colorectal cancer metastases (mCRC) in older patients.

methodsA literature search was conducted in PubMed, EMBASE, Cochrane and ClinicalTrials.gov for studies published since 2000 that investigated the short- and long-term outcomes of regional treatments (surgical or non-surgical) for mCRC in patients aged ≥65 years. Pooled data analyses were conducted by calculating the risk ratio (RR), mean differences (MD) and hazard ratio (HR) between older and younger patients or between two different approaches in older patients.

resultsAfter screening 266 articles, 29 were included in this review. These studies reported the outcomes of surgery (n = 19) and non-surgical local ablation treatments (n = 3) for CRC metastases in older vs. younger patients or compared the outcomes of different interventions in older patients (n = 7). When comparing older vs. younger patients undergoing liver surgery for mCRC, pooled data analysis showed higher postoperative mortality [RR = 2.53 (95%CI: 2.00-3.21)] and shorter overall survival [HR = 1.17 (95%CI: 1.07-1.18)] in older patients, whereas no differences in operative outcomes, postoperative complications and disease-free survival were found. When comparing laparoscopy vs. open surgery for liver resection in older mCRC patients, laparoscopy was associated with fewer postoperative complications [RR = 0.27 (95%CI: 0.10-0.73)].

conclusionLiver resection for mCRC should not be disregarded a priori in older patients, who show similar operative and postoperative outcomes as younger patients. However, clinicians should consider that they are at increased risk of postoperative mortality and have a worse overall survival, which may reflect comorbidities and frailty.

Indexed as

Age FactorsColorectal NeoplasmsHumansNeoplasm MetastasisPostoperative ComplicationsRisk

Identifiers

PMID32320417
PMCPMC7176093

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.