Treatment and complications in elderly stage III colon cancer patients in the Netherlands
- 1 April 2013
- journal article
- Published by Elsevier BV in Annals of Oncology
- Vol. 24 (4), 974-979
- https://doi.org/10.1093/annonc/mds576
Abstract
We evaluated which patient factors were associated with treatment tolerance and outcome in elderly colon cancer patients. Population-based data from five regions included in the Netherlands Cancer Registry were used. Patients with resected stage III colon cancer aged ≥75 years diagnosed in 1997-2004 who received adjuvant chemotherapy (N = 216) were included as well as a random sample (N = 341) of patients who only underwent surgery. The most common motives for withholding adjuvant chemotherapy were a combination of high age, co-morbidity and poor performance status (PS, 43%) or refusal by the patient or family (17%). In 57% of patients receiving chemotherapy, adaptations were made in treatment regimens. Patients who received adjuvant chemotherapy developed more complications (52%) than those with surgery alone (41%). For the selection of patients who had survived the first year after surgery, receiving adjuvant chemotherapy resulted in better 5-year overall survival (52% versus 34%), even after adjustment for differences in age, co-morbidity and PS. Despite high toxicity rates and adjustments in treatment regimens, elderly patients who received chemotherapy seemed to have a better survival. Prospective studies are needed for evaluating which patient characteristics predict the risks and benefits of adjuvant chemotherapy in elderly colon cancer patients.Funding Information
- Dutch Cancer Society (IKZ 2007–3865)
This publication has 36 references indexed in Scilit:
- Comparative Effectiveness of Oxaliplatin vs Non–Oxaliplatin-containing Adjuvant Chemotherapy for Stage III Colon CancerJNCI Journal of the National Cancer Institute, 2012
- Importance of the First Postoperative Year in the Prognosis of Elderly Colorectal Cancer PatientsAnnals of Surgical Oncology, 2011
- Lack of Survival Gain for Elderly Women with Breast CancerThe Oncologist, 2011
- Improved survival of colon cancer due to improved treatment and detection: a nationwide population-based study in The Netherlands 1989–2006Annals of Oncology, 2010
- Large age and hospital-dependent variation in administration of adjuvant chemotherapy for stage III colon cancer in southern NetherlandsAnnals of Oncology, 2010
- Marked improvements in survival of patients with rectal cancer in the Netherlands following changes in therapy, 1989–2006European Journal of Cancer, 2010
- Evidence for Cure by Adjuvant Therapy in Colon Cancer: Observations Based on Individual Patient Data From 20,898 Patients on 18 Randomized TrialsJournal of Clinical Oncology, 2009
- Overcoming challenges associated with chemotherapy treatment in the senior adult populationCritical Reviews in Oncology/Hematology, 2008
- Survival Following Recurrence in Stage II and III Colon Cancer: Findings From the ACCENT Data SetJournal of Clinical Oncology, 2008
- Cancer patients, doctors and nurses vary in their willingness to undertake cancer chemotherapyEuropean Journal of Cancer, 1995