Korean J Intern Med.
2018 Nov;33(6):1182-1193. 10.3904/kjim.2016.181.
Clinical characteristics and treatment propensity in elderly patients aged over 80 years with colorectal cancer
- Affiliations
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- 1Division of Medical Oncology, Department of Internal Medicine, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. insookwoo@catholic.ac.kr
- 2Division of Hematology-Oncology, Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea.
- 3Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 4Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 5Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- KMID: 2426403
- DOI: http://doi.org/10.3904/kjim.2016.181
Abstract
- BACKGROUND/AIMS
Elderly patients (≥ 80 years) with colorectal cancer (CRC) tend to avoid active treatment at the time of diagnosis despite of recent advances in treatment. The aim of this study was to determine treatment propensity of elderly patients aged ≥ 80 years with CRC in clinical practice and the impact of anticancer treatment on overall survival (OS).
METHODS
Medical charts of 152 elderly patients (aged ≥ 80 years) diagnosed with CRC between 1998 and 2012 were retrospectively reviewed. Patients' clinical characteristics, treatment modalities received, and clinical outcome were analyzed.
RESULTS
Their median age was 82 years (range, 80 to 98). Of 152 patients, 148 were assessable for the extent of the disease. Eighty-two of 98 patients with localized disease and 28 of 50 patients with metastatic disease had received surgery or chemotherapy or both. Surgery was performed in 79 of 98 patients with localized disease and 15 of 50 patients with metastatic disease. Chemotherapy was administered in only 24 of 50 patients with metastatic disease. Patients who received anticancer treatment according to disease extent showed significantly longer OS compared to untreated patients (localized disease, 76.2 months vs. 15.4 months, p = 0.000; metastatic disease, 9.9 months vs. 2.6 months, p = 0.001). Along with anticancer treatment, favorable performance status (PS) was associated with longer OS in multivariate analysis of clinical outcome.
CONCLUSIONS
Elderly patients aged ≥ 80 years with CRC tended to receive less treatment for metastatic disease. Nevertheless, anticancer treatment in patients with favorable PS was effective in prolonging OS regardless of disease extent.
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