Adjuvant chemotherapy outcomes in patients over 65 years with early stage colorectal carcinoma


Civelek B., AKSOY S., Sendur M. A. N. , Yazici O., Kanmaz H., Kos F. T. , ...More

Journal of B.U.ON., vol.19, no.4, pp.906-912, 2014 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 19 Issue: 4
  • Publication Date: 2014
  • Journal Name: Journal of B.U.ON.
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.906-912
  • Keywords: adjuvant chemotherapy, colorectal cancer, elderly patients, FOLFOX-4, FUFA, III COLON-CANCER, ELDERLY-PATIENTS, FLUOROURACIL, SURVIVAL, THERAPY, OXALIPLATIN, LEUCOVORIN, SAFETY, AGE

Abstract

Purpose: To evaluate the clinicopathological characteristics and the outcomes of adjuvant chemotherapy of patients with colorectal cancer aged ≥65 years. Methods: Between March 2003 and December 2010, the medical files of 562 colorectal cancer patients ≥65 years of age who were under follow-up in Ankara Numune Educational Hospital, Department of Medical Oncology, were retrospectively analyzed. Only 210 patients with non-metastatic disease at the time of diagnosis and those who had undergone surgical resection were included in the study. Results: The patient median age was 71 years (range 65-87). Of the patients, 115 (54.8%) were males and 95 (45.2%) females. The most common involvement site was the rectum (41.4%), followed by sigmoid colon (21.9%). According to the TNM staging, 12.4% patients had stage I, 48.6% stage 11, and 39% stage 111 disease. At the time of diagnosis 19 patients (9%) had ECOG PS 0, 112 (53.3%) ECOG PS 1, 61 (29%) ECOG PS 2, and 16 (7.7%) ECOG PS 3. Of the patients, 141 (66.5%) were administered adjuvant chemotherapy, whereas 69 patients (33%) were not. Thirty nine (18.6%) patients with adjuvant chemotherapy received fluorouracil/folinic acid (FUFA) weekly, 59 (28%) received FUFA infusion, and 43 (21%) received oxaliplatin, folinic acid and 5-fluorouracil (FOLFOX-4) regimen. The median follow-up was 27 months (range 1-116). Disease free survival (DFS) was not reached during the follow-up period. The estimated overall survival (OS) was 68.8 months (range 48.5-73.0). Sixty six (31%) patients died during follow-up. Conclusion: Elderly patients with high risk for recurrence of colorectal cancer must receive adjuvant chemotherapy after curative surgery. Infusional FUFA seems more effective than other regimens.