Cáncer colorrectal en el anciano. Tratamiento quirúrgico, quimioterápico y aportación desde la geriatría

Sáez-López, Pilar; Vegas, Elena Filipovich; Martínez-Peromingo, Javier; Mola, Sonia Jiménez

doi:10.1016/j.regg.2016.10.002

Cited by 10 publications

(6 citation statements)

References 106 publications

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“…Consequently, the prevalence of frailty in older individuals with CRC and surgical indication ranges between 25% and 46%, a variability that depends on both the population studied and the tools used to measure it [54]. It has been proposed that, regarding CRC treatment in the elderly, standard approaches may be offered to robust CRC patients while a need for an individualized therapeutic plan must be considered on frail CRC patients [55].…”

Section: Frailtymentioning

confidence: 99%

Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

González-Senac

Mayordomo-Cava

Macías-Valle

et al. 2021

IJERPH

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Six out of every 10 new colorectal cancer (CRC) diagnoses are in people over 65 years of age. Current standardized surgical approaches have proved to be tolerable on the elderly population, although post-operative complications are more frequent than in the younger CRC population. Frailty is common in elderly CRC patients with surgical indication, and it appears to be also associated with an increase of post-operative complications. Fast-track pathways have been developed to assure and adequate post-operative recovery, but comprehensive geriatric assessments (CGA) are still rare among the preoperative evaluation of elderly CRC patients. This review provides a thorough study of the effects that a CGA assessment and a geriatric intervention have in the prognosis of CRC elderly patients with surgical indication.

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Section: Frailtymentioning

confidence: 99%

Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

González-Senac

Mayordomo-Cava

Macías-Valle

et al. 2021

IJERPH

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“…Lund CM et al conducted a study in older patients and obtained similar rates of EGFR 15 mutation, rates that in turn resembled those of other studies developed in the adult population. 21 Regarding the type of antineoplastic treatment, the choice of treatment scheme was adjusted to the proposals in the clinical practice guidelines. 11 The ESMO guidelines classify patients with advanced or metastatic disease as fit or unfit.…”

Section: Discussionmentioning

confidence: 99%

“…conducted a study in older patients and obtained similar rates of EGFR 15 mutation, rates that in turn resembled those of other studies developed in the adult population. 21…”

Section: Discussionmentioning

confidence: 99%

Analysis of first-line treatment in older patients with metastasic colorectal cancer

Martínez

Ferrández

Rello

et al. 2021

J Oncol Pharm Pract

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Objective The purpose of this study was to analyse the effectiveness and safety of first-line treatment of metastatic colorectal cancer (CRCm) in older patients treated in a tertiary hospital. Material and methods This was an observational and retrospective study, including patients aged 75 years or older, with CRCm, who received chemotherapy treatment in 2017. The main variables studied were type of treatment, Progression-Free Survival (PFS), Overall Survival (OS), dose reductions, and treatment delays due to adverse events. Results A total of 59 patients (71.2% men) with a median age of 76 years were enrolled in this study. About 70% presented colon cancer, with the left colon being the most frequent location. They were treated with 9 different schemes, in most cases using polychemotherapy and biological agents. The median PFS and OS was 12 and 30 months, respectively. A total of 23/59 of patients started treatment at doses lower than recommended in the clinical practice guidelines. In terms of safety, 34/59 of patients had at least one dose reduction, and 30/59 suffered one treatment delay. The most frequent adverse reactions were asthenia, peripheral neuropathy, diarrhoea, and palmoplantar erythrodysesthesia. Conclusion Our patients presented baseline clinical characteristics similar to the general adult population, with no tumour characteristics associated with advanced age. The efficacy and toxicity were similar to those in the clinical trials, although our patients had more dose reductions. Considering the heterogeneity of patients and in the absence of clinical trials in the older population, real-life studies can be very useful.

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“…The risk factors of colon cancer include age; a diet rich in red meat and low in fruits and vegetables [11,12]; obesity and physical inactivity [13]; smoking; alcohol consumption; microbiota composition [14,15]; type-2 diabetes; irritable bowel syndrome (IBS); relatives with colon cancer or polyps [16,17]; and inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). Some data suggest that IBD increases the risk of developing colon cancer by 0.5% to 1.0% annually [18,19].…”

Section: Risk Factorsmentioning

confidence: 99%

Colon Cancer Pharmacogenetics: A Narrative Review

et al. 2022

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Currently, metastatic colon cancer is treated with monotherapeutic regimens such as folinic acid, fluorouracil, and oxaliplatin (FOLFOX), capecitabine and oxaliplatin (CapeOX), and leucovorin, fluorouracil, and irinotecan hydrochloride (FOLFIRI). Other treatments include biological therapies and immunotherapy with drugs such as bevacizumab, panitumumab, cetuximab, and pembrolizumab. After the research, it was found that some mutations make those treatments not as effective in all patients. In this bibliographic review, we investigated the pharmacogenetic explanations for how mutations in the genes coding for rat sarcoma virus (RAS) and rapidly accelerated fibrosarcoma (RAF) reduce the effectiveness of these treatments and allow the continued proliferation of tumors. Furthermore, we note that patients with mutations in the dihydropyrimidine dehydrogenase (DPDY) gene usually require lower doses of therapies such as 5-fluorouracyl (5-FU) and capecitabine to avoid severe adverse effects. Some other mutations in the thymidylate synthase gene (TSYM), methylenetetrahydrofolate reductase gene (MTHFR), and ATP binding cassette transporter B (ABCB1 and ABCB2) affect efficacy and security of the treatments. It is important to address the clinical implication of the oncologist in the study of gene mutations than can influence in the antitumoral response and safety of colon cancer treatments.

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Cáncer colorrectal en el anciano. Tratamiento quirúrgico, quimioterápico y aportación desde la geriatría

Cited by 10 publications

References 106 publications

Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

Colorectal Cancer in Elderly Patients with Surgical Indication: State of the Art, Current Management, Role of Frailty and Benefits of a Geriatric Liaison

Analysis of first-line treatment in older patients with metastasic colorectal cancer

Colon Cancer Pharmacogenetics: A Narrative Review

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