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Elderly patients with colon cancer: a medical oncologist’s perspective.


Authors: MUDr. Jindřich Kopecký, Ph.D. 1;  MUDr. Peter Priester 1;  MUDr. Veronika Molnárová 1;  MUDr. Petronela Trojanová 1;  MUDr. Ondřej Kubeček 1;  doc. MUDr. Ladislav Slováček, Ph.D. 2,3;  doc. MUDr. Otakar Kopecký, CSc. 4
Authors‘ workplace: Klinika onkologie a radioterapieLF UK a FN Hradec Králové 1;  ordinace praktického lékaře pro dospělé, Poliklinika IV, Hradec Králové – Věkoše 2;  ambulance léčby chronické bolesti a paliativní medicíny MUDr. Eva Richterová –HK, s. r. o., Hradec Králové 3;  oddělení klinické onkologie a oddělení klinické mikrobiologie, Oblastní nemocnice Náchod a. s. 4
Published in: Geriatrie a Gerontologie 2016, 5, č. 2: 65-69
Category: Review Article

Overview

There is a trend of increasing colon cancer incidence and prevalence accross developed countries. More than a half of all newly diagnosed patients are 65 years old or more. Considering the evolution of demographic curve, the treatment of colon cancer in elderly patients is becoming an emerging issue. Geriatric patients with colon cancer represent a heterogeneous group. Each patient should therefore be approached individually and discussed within multidisciplinary boards. The treatment strategy of geriatric patients with colon cancer depends on multiple factors including performance status of the patient, presence of comorbidities, life expectancy, risks arising from both, cancer and the treatment itself, and last but not least preferences of the patient. The following article presents a medical oncologist‘s perspective.

KEYWORDS:
colon cancer – geriatrics – adjuvant treatment – medical oncology


Sources

1. Dusek L, Muzik J, Maluskova D, et al. Cancer incidence and mortality in the Czech Republic. Klin Onkol 2014; 27(6): 406–423.

2. Dusek L, Pavlík T, Májek O, et al. Estimating cancer incidence, prevalence, and the number of cancer patients treated with antitumor therapy in 2015 and 2020 – analysis of the Czech National Cancer Registry. Klin Onkol 2015; 28(1): 30–43.

3. Šnejdrlová M, Kalvach Z. Funknční stav v pokročilém stáří a genetická dispozice k dlouhověkosti. Med Praxi 2008; 5(4): 157–160.

4. Kalvach Z, Zadák Z, Jirák R a kol. Geriatrie a gerontologie. Praha: Grada Publishing 2004: 165–200.

5.World Health Statistics 2014. Online 6. 4. 2016. Dostupné z: http://apps.who.int/iris/bitstream/10665/112738/1/9789240692671_eng.pdf.

6. Gross CP, McAvay GJ, Krumholz HM, et al. The effect of age and chronic illness on life expectancy after a diagnosis of colorectal cancer: implications for screening. Ann Intern Med 2006; 145(9): 646–653.

7. Gross CP, Guo Z, Mc Avay GJ, et al. Multimorbidity and survival in older persons with colorectal cancer. J Am Geriatr Soc 2006; 54(12): 1898–1904.

8. Mitry E, Douillard JY, Van Cutsem E, et al. Predictive factors of survival in patients with advanced colorectal cancer: An individual data analysis of 602 patients included in irinotecan phase III trials. Ann Oncol 2004; 15(7): 1013–1017.

9. D’Andre S, Sargent DJ, Cha SS, et al. 5-Fluorouracil-based chemotherapy for advanced colorectal cancer in elderly patients: A North Central Cancer Treatment Group study. Clin Colorectal Cancer 2005; 4(5): 325–333.

10. Extermann M. Assessing elderly cancer patients. The SIOG Task Force on Oncogeriatric Assessment presents its findings to the experts. Cancer Futures 2003; 2(3–4): 155–157.

11. Pope D, Ramesh H, Gennari R, et al. Pre-operative assessment of cancer in the elderly (PACE): a comprehensive assessment of underlying characteristics of elderly cancer patients prior to elective surgery. Surg Oncol 2006; 15(4): 189–197.

12. Simmonds PD, Best L, George S, et al. Surgery for colorectal cancer in elderly patients: a systematic review. Lancet 2000; 356(9234): 968–974.

13. Potosky AL, Harlan LC, Kaplan RS, et al. Age, sex, and racial differences in the use of standard adjuvant therapy for colorectal cancer. J Clin Oncol 2002; 20(5): 1192–1202.

14. Schrag D, Cramer LD, Bach PB, et al. Age and adjuvant chemotherapy use after surgery for stage III colon cancer. J Natl Cancer Inst 2001; 93(11): 850–857.

15. Lewis JH, Kilgore ML, Goldman DP, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 2003; 21(7): 1383–1389.

16. Popescu RA, Norman A, Ross PJ, et al. Adjuvant or palliative chemotherapy for colorectal cancer in patients 70 years or older. J Clin Oncol 1999; 17(8): 2412–2418.

17. Sargent DJ, Goldberg RM, Jacobson SD, et al. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 2001; 345(15): 1091–1097.

18. Sundararajan V, Mitra N, Jacobson JS, et al. Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with nodepositive colon cancer. Ann Intern Med 2002; 136(5): 349–357.

19. Sanoff HK, Carpenter WR, Stürmer T, et al. Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol 2012; 30(21): 2624–2634.

20. Chau I, Norman AR, Cunningham D, et al. A randomised comparison between 6 months of bolus fluorouracil/leucovorin and 12 weeks of protracted venous infusion fluorouracil as adjuvant treatment in colorectal cancer. Ann Oncol 2005; 16(4): 549–557.

21. Yothers G, O‘ Connell MJ, Allegra CJ, et al. Oxaliplatin as adjuvant therapy for colon cancer: updated results of NSABP C-07 trial, including survival and subset analyses. J Clin Oncol 2011; 29(28): 3768–3774.

22. Seymour MT, Maughan TS, Ledermann JA, et al. Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. Lancet 2007; 370(9582): 143–152.

23. Koopman M, Antonini NF, Douma J, et al. Sequential versus combination chemotherapy with capecitabine, irinotecan, and oxaliplatin in advanced colorectal cancer (CAIRO): a phase III randomised controlledtrial. Lancet 2007; 370(9582): 135–142.

24. Souglakos J, Pallis A, Kakolyris S, et al. Combination of Irinotecan (CPT-11) plus 5-Fluorouracil and Leucovorin (FOLFIRI Regimen) as first line treatment for elderly patients with metastatic colorectal cancer: a phase II trial. Oncology 2005; 69(5): 384–390.

25. Folprecht G, Rougier P, Saltz L, et al. Irinotecan in first line therapy of elderly and non-elderly patients with metastatic colorectal cancer: meta-analysis of four trials investigating 5-FU and irinotecan (abstr 3578). Proc Am Soc Clin Oncol 2006; 24: 165.

26. Feliu J, Salud A, Escudero P, et al. XELOX (capecitabine plus oxaliplatin) as first-line treatment for elderly patients over 70 years of age with advanced colorectal cancer. Br J Cancer 2006; 94(7): 969–975.

27. Cunningham D, Humblet Y, Siena S, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 2004; 351(4): 337–345.

28. Kabbinavar FF, Hurwitz HI, Yi J, et al. Addition of bevacizumab to fluorouracil-based first-line treatment of metastatic colorectal cancer: pooled analysis of cohorts of older patients from two randomized clinical trials. J Clin Oncol 2009; 27(2): 199–205.

29. Cassidy J, Saltz LB, Giantonio BJ, et al. Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies. J Cancer Res Clin Oncol 2010; 136(5): 737–743.

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