Adjuvant Therapy of Colorectal Cancer in Older People
Colorectal cancer (CRC) is the fourth cause of cancer deaths. More than one-third of colon cancers are stage III at presentation; their 5-year relative survival is 69 %.
Among the high-incidence cancers, CRC has the highest median age at presentation. Thus, the administration of adjuvant therapy after curative surgery for elderly patients remains a burning question in daily practice.
In the adjuvant setting, while there is an advantage in relapse-free survival with adjuvant therapy, there is no evidence-based survival benefit for adjuvant therapy due to confounding non-cancer-related deaths. However, with an optimal and careful management of relapses or second cancers, a survival benefit with adjuvant therapy is possible in some elderly patients. The use of a comprehensive geriatric assessment is strongly recommended to evaluate chemotherapy appropriateness. Elderly patients with good physical condition are able to receive combination therapy in a similar fashion to younger patients.
KeywordsColorectal cancer Elderly Stage III Adjuvant chemotherapy Fluoropyrimidines Oxaliplatin Older patients Recurrence Survival
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