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 (SCI-Expanded) 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 (SCI-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
  • Lokman Hekim University Affiliated: No

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.