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Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/25525

Title: Management of Colorectal Liver Metastases in Older Patients: a Decision Analysis
Authors: Yang, Simon Yie
Advisor: Law, Calvin
Department: Health Policy, Management and Evaluation
Keywords: surgical oncology
Issue Date: 31-Dec-2010
Abstract: 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.
URI: http://hdl.handle.net/1807/25525
Appears in Collections:Master
The Institute of Health Policy, Management and Evaluation - Master theses

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