Clinical characteristics and treatment propensity in elderly patients aged over 80 years with colorectal cancer

Abstract

Background/AimsElderly patients (≥ 80 years) with colorectal cancer (CRC) tend to avoid active treatment at the time of diagnosis despite of recent advances in treatment. The aim of this study was to determine treatment propensity of elderly patients aged ≥ 80 years with CRC in clinical practice and the impact of anticancer treatment on overall survival (OS).MethodsMedical charts of 152 elderly patients (aged ≥ 80 years) diagnosed with CRC between 1998 and 2012 were retrospectively reviewed. Patients’ clinical characteristics, treatment modalities received, and clinical outcome were analyzed.ResultsTheir median age was 82 years (range, 80 to 98). Of 152 patients, 148 were assessable for the extent of the disease. Eighty-two of 98 patients with localized disease and 28 of 50 patients with metastatic disease had received surgery or chemotherapy or both. Surgery was performed in 79 of 98 patients with localized disease and 15 of 50 patients with metastatic disease. Chemotherapy was administered in only 24 of 50 patients with metastatic disease. Patients who received anticancer treatment according to disease extent showed significantly longer OS compared to untreated patients (localized disease, 76.2 months vs. 15.4 months, p = 0.000; metastatic disease, 9.9 months vs. 2.6 months, p = 0.001). Along with anticancer treatment, favorable performance status (PS) was associated with longer OS in multivariate analysis of clinical outcome.ConclusionsElderly patients aged ≥ 80 years with CRC tended to receive less treatment for metastatic disease. Nevertheless, anticancer treatment in patients with favorable PS was effective in prolonging OS regardless of disease extent.

High Serum CA19-9 Concentration Predicts Poor Prognosis in Elderly Patients with Stage IV Colorectal Cancer

“…In the present study, OS was not significantly different between the patients who received mono-chemotherapy ( n = 16, 42.1%) and combination chemotherapy ( n = 22, 57.9%). We report results consistent with those of previous studies [5, 29]; mono-chemotherapy might be acceptable for these patients. However, randomized prospective studies are still needed to further determine the optimal chemotherapy regimen for elderly patients with stage IV CRC.…”

“…In our study, 38 patients (46.3%) received chemotherapy, and they had significantly longer survival than those who did not ( p < 0.0001). This is similar to the result previously reported in another study [5]. Regarding the chemotherapy regimen, some studies reported that combination chemotherapy was not superior to monotherapy in terms of OS in elderly patients with metastatic CRC [5, 29].…”

“…This is similar to the result previously reported in another study [5]. Regarding the chemotherapy regimen, some studies reported that combination chemotherapy was not superior to monotherapy in terms of OS in elderly patients with metastatic CRC [5, 29]. In the present study, OS was not significantly different between the patients who received mono-chemotherapy ( n = 16, 42.1%) and combination chemotherapy ( n = 22, 57.9%).…”

“…Old age (≥75 years) at the time of surgery for stage IV CRC was reported to be an independent risk factor for mortality during the first year after surgery [6]. Additionally, another study showed that a PS of 2–4 was an independent prognostic factor in patients with stage IV CRC aged > 80 years [5]. In the current study, age and PS were poor prognostic factors in univariate analysis, but not in multivariate analysis.…”

“…It was reported that palliative chemotherapy in selected elderly patients (≥80 years) with distant metastasis was considerably associated with improved OS, and oral 5-FU monotherapy in the palliative setting could be a reasonable option for elderly patients [5]. Kim [28] reported that chemotherapy in elderly patients should be individualized based on the nature of the disease, physiological or functional status, and patient’s preference.…”