Long-term quality of life and physical functioning after curative local treatment of colorectal metastases in older patients.

INTRODUCTION: Local therapies with curative intent for patients with metastatic colorectal cancer may lead to a considerable improvement of disease-free and overall survival. Their impact on quality of life (QoL) and physical functioning over time in older patients with metastatic colorectal cancer remains unknown. This study evaluates long-term QoL and physical functioning of older patients with colorectal cancer treated with curative local treatment for metastases. MATERIALS AND METHODS: Patients aged ≥ 70 years with metastatic colorectal cancer treated with local surgical or ablative therapy for metastases, were selected from the nationwide Prospective Dutch ColoRectal Cancer cohort. Baseline QoL and physical functioning, assessed with the EQ-5D-5L, EQ-VAS and EORTC QLQ-C30, were compared with scores at 3, 6 and 12 months. Subgroup analyses were performed based on risk of frailty defined by the G8 questionnaire. Secondary outcomes included overall survival and factors associated with QoL and physical functioning over time. RESULTS: In this cohort of 122 older patients (median age 74 years), linear mixed model analyses revealed no clinically relevant changes in QoL and physical functioning over time. Physical functioning showed a decline after 3 months that did not reach clinically relevant levels, and recovered to baseline levels thereafter. Overall survival was approximately 100% at 3 months and 90% at 12 months. Having ≥4 comorbidities was associated with a declining QoL and physical functioning over time. CONCLUSION: QoL and physical functioning are well preserved in older patients with metastatic colorectal cancer selected for local therapy of metastases with curative intent.