TOPLINE

Older patients with metastatic colorectal cancer who received curative local surgical or ablative treatment for metastases maintained quality of life (QOL) over 12 months; physical functioning declined temporarily at 3 months but did not reach clinically relevant levels of decline at any timepoint.

METHODOLOGY

• Researchers analysed data from the Prospective Dutch Colorectal Cancer cohort, including 122 patients aged 70 years or older (median age, 74 years; 62% men) with metastatic colorectal cancer who received curative local surgical or ablative therapy between 2012 and 2023.
• Metastatic disease was limited to a single site in 84% of patients, with the liver being the most common site (67%), and wedge resection was performed in 40% of liver metastasis cases.
• QOL was assessed using the EuroQoL five-dimension five-level questionnaire and EuroQol visual analog scale (EQ-VAS), and physical functioning was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; both outcomes were assessed at baseline and 3, 6, and 12 months after treatment.
• The researchers evaluated changes over time, with adjustments for age, comorbidities, living situation, primary site of metastasis, and chemotherapy use.

TAKEAWAY

• QOL measured using the EQ-VAS remained stable over time, with no clinically relevant changes at 3, 6, or 12 months compared with baseline in both unadjusted and adjusted models.
• Physical functioning showed a statistically significant decline at 3 months (beta-coefficient, -6.3; 95% CI, -10.8 to -1.8; P = .01), but this decline did not reach the minimal clinically important difference threshold of 10 points; at 6 and 12 months, the scores remained decreased compared with baseline, but the differences were not clinically significant.
• Patients with four or more comorbidities experienced significantly lower QOL and physical functioning over time than those with fewer comorbidities.
• An individual-level analysis revealed that 44% of patients experienced no decline in QOL or physical functioning at 3 months; however, 20%, 16%, and 20% had a clinically relevant decline in QOL alone, physical functioning alone, and both outcomes, respectively.

IN PRACTICE

"Taken together, [the study] findings support the use of local curative treatment in older patients with metastatic colorectal cancer, while underscoring the importance of closely monitoring individual recovery patterns as declines in quality of life or physical functioning may occur despite a relatively extended overall survival rate," the authors of the study wrote.

SOURCE

The study was led by Trishika R.R. Binda, Leiden University Medical Centre, Leiden, Netherlands. It was published online on September 13, 2026, in the European Journal of Surgical Oncology.

LIMITATIONS

The small sample size and loss to follow-up may have introduced selection bias, potentially overestimating positive outcomes as patients with poorer health were more likely to be lost to follow-up. The study was unable to compare postoperative recovery between surgical and ablative therapies due to insufficient sample size. A response shift and regression to the mean may have influenced reported scores, particularly in subgroup analyses of patients who were frail vs those who were not frail.

DISCLOSURES

No funding information was provided for this study. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.