Predicting Functional Recovery and Quality of Life in Older Patients Undergoing Colorectal Cancer Surgery: Real-World Data From the International GOSAFE Study

PURPOSE The GOSAFE study evaluates risk factors for failing to achieve good quality of life (QoL) and functional recovery (FR) in older patients undergoing surgery for colon and rectal cancer.METHODS Patients age 70 years and older undergoing major elective colorectal surgery were prospectively enrolled. Frailty assessment was performed and outcomes, including QoL (EQ-5D-3L) recorded (3/6 months postoperatively). Postoperative FR was defined as a combination of Activity of Daily Living >= 5 + Timed Up & Go test <20 seconds + MiniCog >2.RESULTS Prospective complete data were available for 625/646 consecutive patients (96.9%; 435 colon and 190 rectal cancer), 52.6% men, and median age was 79.0 years (IQR, 74.6-82.9 years). Surgery was minimally invasive in 73% of patients (321/435 colon; 135/190 rectum). At 3-6 months, 68.9%-70.3% patients experienced equal/better QoL (72.8%-72.9% colon, 60.1%-63.9% rectal cancer). At logistic regression analysis, preoperative Flemish Triage Risk Screening Tool >= 2 (3-month odds ratio [OR], 1.68; 95% CI, 1.04 to 2.73; P = .034, 6-month OR, 1.71; 95% CI, 1.06 to 2.75; P = .027) and postoperative complications (3-month OR, 2.03; 95% CI, 1.20 to 3.42; P = .008, 6-month OR, 2.56; 95% CI, 1.15 to 5.68; P = .02) are associated with decreased QoL after colectomy. Eastern Collaborative Oncology Group performance status (ECOG PS) >= 2 is a strong predictor of postoperative QoL decline in the rectal cancer subgroup (OR, 3.81; 95% CI, 1.45 to 9.92; P = .006). FR was reported by 254/323 (78.6%) patients with colon and 94/133 (70.6%) with rectal cancer. Charlson Age Comorbidity Index >= 7 (OR, 2.59; 95% CI, 1.26 to 5.32; P = .009), ECOG >= 2 (OR, 3.12; 95% CI, 1.36 to 7.20; P = .007 colon; OR, 4.61; 95% CI, 1.45 to 14.63; P = .009 rectal surgery), severe complications (OR, 17.33; 95% CI, 7.30 to 40.8; P < .001), fTRST >= 2 (OR, 2.71; 95% CI, 1.40 to 5.25; P = .003), and palliative surgery (OR, 4.11; 95% CI, 1.29 to 13.07; P = .017) are risk factors for not achieving FR.CONCLUSION The majority of older patients experience good QoL and stay independent after colorectal cancer surgery. Predictors for failing to achieve these essential outcomes are now defined to guide patients' and families' preoperative counseling

Quality of life in older adults after major cancer surgery: the GOSAFE international study

Abstract Background Accurate quality of life (QoL) data and functional results after cancer surgery are lacking for older patients. The international, multicenter Geriatric Oncology Surgical Assessment and Functional rEcovery after Surgery (GOSAFE) Study compares QoL before and after surgery and identifies predictors of decline in QoL. Methods GOSAFE prospectively collected data before and after major elective cancer surgery on older adults (≥70 years). Frailty assessment was performed and postoperative outcomes recorded (30, 90, and 180 days postoperatively) together with QoL data by means of the three-level version of the EuroQol five-dimensional questionnaire (EQ-5D-3L), including 2 components: an index (range = 0-1) generated by 5 domains (mobility, self-care, ability to perform the usual activities, pain or discomfort, anxiety or depression) and a visual analog scale. Results Data from 26 centers were collected (February 2017-March 2019). Complete data were available for 942/1005 consecutive patients (94.0%): 492 male (52.2%), median age 78 years (range = 70-95 years), and primary tumor was colorectal in 67.8%. A total 61.2% of all surgeries were via a minimally invasive approach. The 30-, 90-, and 180-day mortality was 3.7%, 6.3%, and 9%, respectively. At 30 and 180 days, postoperative morbidity was 39.2% and 52.4%, respectively, and Clavien-Dindo III-IV complications were 13.5% and 18.7%, respectively. The mean EQ-5D-3L index was similar before vs 3 months but improved at 6 months (0.79 vs 0.82; P < .001). Domains showing improvement were pain and anxiety or depression. A Flemish Triage Risk Screening Tool score greater than or equal to 2 (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.13 to 2.21, P = .007), palliative surgery (OR = 2.14, 95% CI = 1.01 to 4.52, P = .046), postoperative complications (OR = 1.95, 95% CI = 1.19 to 3.18, P = .007) correlated with worsening QoL. Conclusions GOSAFE shows that older adults’ preoperative QoL is preserved 3 months after cancer surgery, independent of their age. Frailty screening tools, patient-reported outcomes, and goals-of-care discussions can guide decisions to pursue surgery and direct patients’ expectations

Search for massive long-lived particles decaying semileptonically at root s=13 TeV

A search is performed for massive long-lived particles (LLP) decaying semileptonically into a muon and two quarks. Two kinds of LLP production processes were considered. In the first, a Higgs-like boson with mass from 30 to 200 GeV is produced by gluon fusion and decays into two LLPs. The analysis covers LLP mass values from 10 GeV up to about one half the Higgs-like boson mass. The second LLP production mode is directly from quark interactions, with LLP masses from 10 to 90 GeV. The LLP lifetimes considered range from 5 to 200 ps. This study uses LHCb data collected from proton-proton collisions at sqrt(s)=13 TeV, corresponding to an integrated luminosity of 5.4 1/fb. No evidence of these long-lived states has been observed, and upper limits on the production cross-section times branching ratio have been set for each model considered

Search for the rare decay B+→ µ+µ−µ+νµ

A search for the rare leptonic decay B+→μ+μ−μ+νμ is performed using proton-proton collision data corresponding to an integrated luminosity of 4.7fb−1 collected by the LHCb experiment. The search is carried out in the region where the lowest of the two μ+μ− mass combinations is below 980MeV/c2 . The data are consistent with the background-only hypothesis and an upper limit of 1.6×10−8 at 95% confidence level is set on the branching fraction in the stated kinematic region

Measurement of the CP-violating phase ϕs from Bs0→J/ψπ+π− decays in 13 TeV pp collisions

Decays of Bs0 and B‾0s mesons into J/ψπ+π− final states are studied in a data sample corresponding to 1.9 fb−1 of integrated luminosity collected with the LHCb detector in 13 TeV pp collisions. A time-dependent amplitude analysis is used to determine the final-state resonance contributions, the CP-violating phase ϕs=−0.057±0.060±0.011 rad, the decay-width difference between the heavier mass Bs0 eigenstate and the B0 meson of −0.050±0.004±0.004 ps−1, and the CP-violating parameter |λ|=1.01−0.06+0.08±0.03, where the first uncertainty is statistical and the second systematic. These results are combined with previous LHCb measurements in the same decay channel using 7 TeV and 8 TeV pp collisions obtaining ϕs=0.002±0.044±0.012 rad, and |λ|=0.949±0.036±0.019