Adjuvant treatment for elderly patients with colon cancer. An observational study.
BACKGROUND
Adjuvant 5-fluoruracil-based chemotherapy significantly reduces mortality in patients with stage II-III colon cancer, but is less prescribed with rising age. In this study we were interested in the pattern of adjuvant treatment and possible effects on survival among elderly patients.


METHODS
From January to December 2004, 63 questionnaires on the management of stage II-III resected colon cancer patients aged over 70 years, collected from 10 Italian Centres, were retrospectively examined. Determinants of receipt of adjuvant chemotherapy and their relation to survival were considered.


RESULTS
The proportion of elderly patients receiving adjuvant chemotherapy was 79.4%, distinct of age, gender, educational level and comorbidities. Grade 3-4 toxicities were the following: haematological in 4 (8.5.%) patients, mucositis in 4 (8.5%), diarrhoea in 2 (4.2%) and nausea in 1 (2.1%). The disease-free survival (DFS) and overall survival (OS) at two years were 79.9% and 95.6%, respectively. Due to the paucity of events, the impact of prognostic factors (patient's age and comorbidity, tumour stage and grade) on DFS and OS could not be assessed.


CONCLUSIONS
An increasing proportion of elderly patients with colon cancer may be treated with a tolerability and OS similar to those observed in the younger population. Development of age-based guidelines and increased awareness of both physicians and patients through education is important to prevent undertreatment of those elderly patients who are eligible for chemotherapy.
Pasetto
Lara Maria
LM
Istituto Oncologico Veneto, IRCCS, Medical Oncology 2nd, Padova, Italy. laramary@libero.it
Falci
Cristina
C
Basso
Umberto
U
Gasparini
Giampietro
G
D'Andrea
Mario
M
Bonginelli
Paola
P
Bajetta
Emilio
E
Platania
Marco
M
Alabiso
Oscar
O
Miraglia
Stefania
S
Bertona
Erica
E
Oniga
Francesco
F
Biason
Rita
R
Chetrì
Maria Concetta
MC
Fedele
Palma
P
Massara
Giovanna
G
Romaniello
Incoronata
I
Negru
Maria Emanuela
ME
Luchena
Giovanna
G
Giordano
Monica
M
Buzzi
Franco
F
Ricottao
Riccardo
R
Sienao
Salvatore
S
Monfardini
Silvio
S