SP 3.16 “After the MDT Decision”: An Audit of Management and Survival in Colorectal Cancer Patients Allocated to Best Supportive Care
Lakshmi Suresh, Hannah Javanmard-Emamghissi, Katherine E SmithAbstract
Background
Prognosis in advanced colorectal cancer is influenced by primary tumour site, metastatic burden, comorbidities and frailty. However, little is known about the clinical course of patients once the decision has been made that their care goals are palliative. This project aimed to evaluate the survival time of colorectal cancer patients managed palliatively and establish what care these patients received.
Method
A retrospective audit of patients deemed for palliative care after discussion at MDT at the Royal Derby Hospital July 2022- April 2023 was carried out. Data collected included TNM staging, primary tumour site, details of palliative treatment, and date of death.
Results
Seventy-six patients were included, with a mean age at diagnosis of 79.5 years. Colonic primaries accounted for 62% (n=47) of diagnoses, with rectal primaries accounting for 38% (n=29). Twenty percent of patients (n=15) had metastatic disease at the time of decision to palliate. Twenty-nine patients were referred to palliative oncology: 14 (48%) had palliative radiotherapy and none had chemotherapy. The overall median survival was 16 months [IQR 7-25.5]. Patients with a colonic primary had a median survival of 14 months compared to 21 months for rectal primaries (p= 0.35). The median survival time of patients with liver metastases at presentation was 7 months [IQR 4-12] compared to 2 months [IQR 1-15] in those with lung metastases (p=0.41).
Conclusion
Colorectal cancer patients managed palliatively had expectedly poor survival, with worse survival in the context of colonic rather than rectal primaries and in metastatic lung disease.