Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013

Abstract

Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in Europe and worldwide, with the peak incidence in patients >70 years of age. However, as the treatment algorithms for the treatment of patients with CRC become ever more complex, it is clear that a significant percentage of older CRC patients (>70 years) are being less than optimally treated. This document provides a summary of an International Society of Geriatric Oncology (SIOG) task force meeting convened in Paris in 2013 to update the existing expert recommendations for the treatment of older (geriatric) CRC patients published in 2009 and includes overviews of the recent data on epidemiology, geriatric assessment as it relates to surgery and oncology, and the ability of older CRC patients to tolerate surgery, adjuvant chemotherapy, treatment of their metastatic disease including palliative chemotherapy with and without the use of the biologics, and finally the use of adjuvant and palliative radiotherapy in the treatment of older rectal cancer patients. An overview of each area was presented by one of the task force experts and comments invited from other task force members.

MicroRNA-155 enhances the activation of Wnt/β-catenin signaling in colorectal carcinoma by suppressing HMG-box transcription factor 1

“…Colorectal carcinoma (CRC) is a common type of cancer in developed and developing countries (1). CRC is refractory to current therapeutic strategies, due to the lack of knowledge regarding the molecular mechanisms underlying CRC (2).…”

Risk Factors for Adverse Outcome for Elderly Patients undergoing Curative Oncological Resection for Gastrointestinal Malignancies

“…Screening tools available can be incorporated into the preoperative evaluation of the surgical practice to mitigate complications. Although assessment tools are clearly not an alternative to sound clinical judgment of the surgeon, or honest communication with the patient, there is a growing body of evidence supporting the necessity to use objective scores [9,10]. However, thus far it has been shown that the use of screening tools has not been widely adopted by surgeons [29].…”

“…Currently, it is understood that the older population should not be assessed on chronologic age, but rather frailty, functionality, and dependency [7,8]. The International Society of Geriatric Oncology (SIOG) task force has recommended a Comprehensive Geriatric Assessment (CGA) along with several other screening tools for evaluating an elderly patient for surgery [9,10]. These evaluations have been shown to be predictive of adverse outcomes after an oncological operation in an elderly patient.…”

The N-Hexane Fraction of Myrmecodia Pendans Inhibits Cell Survival and Proliferation in Colon Cancer Cell Line

“…Currently, patients with stage I or II colorectal cancer are treated with surgery, while patients with stage III colorectal cancer are treated with surgery followed by adjuvant chemotherapy, and patients with metastatic colorectal cancer (mCRC) are treated with systemic chemotherapies alone or in combination with targeted biologics [3][4]. However, most of the colon cancer patients develop resistance to adjuvant chemotherapy [5].…”