title: Practical outcome of adjuvant FOLFOX4 chemotherapy in elderly patients with stage III colon cancer: single-center study in Korea.
abstract: OBJECTIVE
  Elderly patients derive similar benefits from 5-fluorouracil-based adjuvant chemotherapy in Stage III colon cancer; however, conflicting data exist regarding additional benefit from oxaliplatin, fluorouracil and leucovorin (FOLFOX) chemotherapy.
  
  
  METHODS
  Single-center, retrospective analysis was performed to compare the safety and efficacy of adjuvant oxaliplatin, fluorouracil and leucovorin-4 chemotherapy in older patients (age ≥65 years) with younger patients with Stage III colon cancer after surgical resection.
  
  
  RESULTS
  Among 391 patients with Stage III colon cancer, 229 patients received adjuvant oxaliplatin, fluorouracil and leucovorin chemotherapy (87 (43.5%) ≥65 years old versus 142 (74.3%) <65 years old). Older patients had similar clinico-pathological characteristics as younger patients except for higher Charlson-Age comorbidity score (median 3.44 versus 2.85, P < 0.01). The estimated 3-year disease-free survival (76.5 versus 80.0%, P = 0.88) and 3-year overall survival (90.9 versus 92.7%, P = 0.98) were similar. Grade 3-4 neutropenia was the only toxicity with higher frequency in the elderly patients (62.1 versus 46.5%, P = 0.02). Elderly patients received a lower relative dose intensity of oxaliplatin (0.76 versus 0.79) and 5-fluorouracil (0.75 versus 0.80, P = 0.009).
  
  
  CONCLUSIONS
  Adjuvant oxaliplatin, fluorouracil and leucovorin chemotherapy resulted in similar efficacy without significant increase in toxicity in older patients aged ≥65 when compared with younger patients with curatively resected Stage III colon cancer. Therefore, for colon cancer patients aged ≥65, oxaliplatin, fluorouracil and leucovorin chemotherapy can be recommended as safe and effective adjuvant chemotherapy after curative surgery in Asia.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam 463-707, Korea. jhkimmd@snubh.org
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Yu Jung
authors.initials: YJ
authors.lastname: Kim
authors.forename: Keun-Wook
authors.initials: KW
authors.lastname: Lee
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Duck-Woo
authors.initials: DW
authors.lastname: Kim
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kang
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Lee
authors.forename: Na Young
authors.initials: NY
authors.lastname: Jang
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Jee Hyun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil