BACKGROUND: The incidence of liver metastases from colorectal cancer (CLM) is on the rise. Older cancer patients are frequently subject to under-treatment. METHODS: A Markov decision model was built to examine the effect on life expectancy (LE) and quality-adjusted life expectancy (QALE) of four strategies – best supportive care (BSC), systemic chemotherapy (SC), radiofrequency ablation (RFA), and hepatic resection (HR). The model was designed to account for both age and comorbidities. RESULTS: In the base case analysis, BSC, SC, RFA, and HR yielded LEs of 11.9, 23.1, 34.8, and 37.0 months, respectively, and QALEs of 7.8, 13.2, 22.0, and 25.0 months, respectively. Model results were sensitive to several variables including age, comorbidity status, and length of model simulation. CONCLUSION: Hepatic resection may be the optimal treatment strategy for healthy older patients with CLM. Treatment decisions in older cancer patients should be individualized and account for patient age, comorbidities, and values.

BACKGROUND: The incidence of liver metastases from colorectal cancer (CLM) is on the rise. Older cancer patients are frequently subject to under-treatment. METHODS: A Markov decision model was built to examine the effect on life expectancy (LE) and quality-adjusted life expectancy (QALE) of four strategies – best supportive care (BSC), systemic chemotherapy (SC), radiofrequency ablation (RFA), and hepatic resection (HR). The model was designed to account for both age and comorbidities. RESULTS: In the base case analysis, BSC, SC, RFA, and HR yielded LEs of 11.9, 23.1, 34.8, and 37.0 months, respectively, and QALEs of 7.8, 13.2, 22.0, and 25.0 months, respectively. Model results were sensitive to several variables including age, comorbidity status, and length of model simulation. CONCLUSION: Hepatic resection may be the optimal treatment strategy for healthy older patients with CLM. Treatment decisions in older cancer patients should be individualized and account for patient age, comorbidities, and values.

Thesis (M. Ed.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 59-66).

Thesis (Ph. D.)--University of Queensland, 2002. / Includes bibliographical references.

published_or_final_version / Mechanical Engineering / Doctoral / Doctor of Philosophy

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

No description available.

No description available.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 4 uppsatser.