Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

Nakayama, Yasuhisa; Kawamura, Hidetaka; Honda, Michitaka; Takano, Yoshinao; Takiguchi, Koichi; Kamiga, Takahiro; Yamazaki, Shigeru; Muto, Atsushi; Shiraso, Satoru; Yamashita, Naoyuki; Iwao, Toshiyasu; Kono, Koji; Konno, Satoshi

doi:10.1007/s10147-021-01909-9

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…The diagnostic and treatment in this age group is challenging, as colonoscopy is an invasive procedure associated with increased risks and incomplete examinations in the elderly or frail patients 34 . On the other hand, several studies point out that the age itself should not be a relevant criterion and suggest geriatric assessment to optimise cancer care pathways as well as including older patients in clinical trials 35,36 . Notwithstanding the above, a north English population-based study found that age remains a major factor in treatment decisions in the UK 37 .…”

Section: Discussionmentioning

confidence: 99%

Incidence, prevalence, and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study

Pedregal-Pascual,

Guarner-Argente,

Tan

et al. 2024

Preprint

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Background: The management of colorectal cancer (CRC) is evolving, with advances in screening and treatment. We leveraged population-based data to generate up-to-date UK estimates of age and sex-specific incidence and prevalence and overall survival for the period 2000-2021. Methods: We analysed nationally representative primary care records from Clinical Practice Research Datalink (CPRD) GOLD, and replicated in CPRD Aurum. We calculated incidence rates, prevalence, and short- and long-term survival stratified by age, sex, and diagnosis year. Results: Unadjusted prevalence increased in the study period, from 15.6 to 46.4/10,000. Overall incidence was 61.5/100,000 person years, increasing in 2000-2011 to drop slightly in 2011-2014, and then plateauing. In contrast, early-onset CRC raised uninterruptedly throughout the study period, from 8.33 to 19.07/100,000 person-years. Overall survival was 78.3%, 51.4% and 38.5% at 1-, 5-, and 10-years respectively, lower in men compared to women. Modest improvements in survival were observed over the study period, particularly for 60-69 year old patients. Conclusion: The overall prevalence of CRC in the UK has tripled in the last 20 years, leading to increased healthcare resource needs and with slight survival improvements. A worrying increasing trend of early-onset CRC is observed, warranting further research into its diagnosis and management.

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Section: Discussionmentioning

confidence: 99%

Incidence, prevalence, and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study

Pedregal-Pascual,

Guarner-Argente,

Tan

et al. 2024

Preprint

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“…Regarding patients older than 80 years old with metastatic disease, those who received intensive chemotherapy, defined as at least two cycles of oxaliplation or irinotecan doublets, had a median overall survival of 21 months. This was not different from the overall survival of metastatic patients of younger age who received similar regimens (median overall survival 24.3 months, adjusted hazard ratio 1.29, 85% confidence interval: 0.84–2.00) [ 53 ]. Reduced-intensity systemic chemotherapy would increase the percentage of older patients that are candidates for therapy and provide the opportunity for a broader subset of patients above the age of 80 years old to derive benefit with a reasonable adverse-effect profile.…”

Section: Survival Outcomes and Intensity Of Therapy In Patients Older...mentioning

confidence: 99%

Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old

Voutsadakis

2023

Medicina

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Background: An increasing proportion of the population of patients with cancer presents at an advanced age, increasing the challenges of successful and well-tolerated treatments. In the older spectrum of the geriatric cancer patients, those older than 80 years old, challenges are even higher because of increasing comorbidities and decreasing organ function reserves. Methods: Studies regarding colorectal cancer presentation, treatment, and prognosis in patients older than 80 years old available in the literature were evaluated and were compiled within a narrative review. Molecular attributes of colorectal cancer in the subset of patients older than 80 years old in published genomic cohorts were also reviewed and were compared with similar attributes in younger patients. Results: Characteristics of colorectal cancer in octogenarians are in many aspects similar to younger patients, but patients older than 80 years old present more often with right colon cancers. Surgical treatment of colorectal cancer in selected patients over 80 years old is feasible and should be pursued. Adjuvant chemotherapy is under-utilized in this population. Although combination chemotherapy is in most cases not advisable, monotherapy with fluoropyrimidine derivatives is feasible and efficacious. Conclusions: Outcomes of colorectal cancer patients over the age of 80 years old may be optimized with a combination of standard treatments adjusted to the individual patient’s functional status and organ reserves. Increased support for the older age group during their colorectal cancer treatment modalities would improve oncologic outcomes with decreasing adverse outcomes of therapies.

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Safety and Efficacy of Lenvatinib in Very Old Patients with Unresectable Hepatocellular Carcinoma

Camera,

Rimini,

Rossari

et al. 2024

Targ Oncol

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Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

Cited by 4 publications

References 23 publications

Incidence, prevalence, and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study

Incidence, prevalence, and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study

Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old

Safety and Efficacy of Lenvatinib in Very Old Patients with Unresectable Hepatocellular Carcinoma

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