Colorectal cancer care in elderly patients: Unsolved issues.
Colorectal cancers are common in elderly patients. However, cancer screening is poorly used after 75. Elderly patients form a heterogeneous population with specific characteristics. Standards of care cannot therefore be transposed from young to elderly patients. Tumour resection is frequently performed but adjuvant chemotherapy is rarely prescribed as there are no clearly established standards of care. In a metastatic setting, recent phase III studies have demonstrated that doublet front-line chemotherapy provided no survival benefit. Moreover, several studies have established the benefit of bevacizumab in association with chemotherapy. There is a lack of evidence for the efficacy of anti-epidermal growth factor antibodies in elderly patients. Geriatric assessments could help to select the adequate treatment strategy for individual patients. Geriatric oncology is now the challenge we have to face, and more specific trials are needed.
Gastroenterology and Digestive Oncology Department, CHU Avicenne, APHP, Bobigny, France. Electronic address: thomas.aparicio@aphp.fr.
Thomas
T
Aparicio
Geriatric Department, CHU Avicenne, APHP, Bobigny, France.
Frederic
F
Pamoukdjian
Radiotherapy Department, CHU Saint Louis, APHP, Paris, France.
Laurent
L
Quero
Hepato-Gastroenterology and Oncology Department, INSERM U866, CHU Dijon, Dijon, France.
Sylvain
S
Manfredi
Surgery Department, CHU Avicenne, APHP, Bobigny, France.
Philippe
P
Wind
Geriatric Department, CHU Henri Mondor, APHP, Créteil, France.
Elena
E
Paillaud
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D018572:Disease-Free Survival; D015577:Geriatric Assessment; D006801:Humans; D008403:Mass Screening; D058990:Molecular Targeted Therapy / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D016032:Randomized Controlled Trials as Topic
D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
Adjuvant therapy; Chemotherapy; Geriatric oncology; Radiotherapy; Targeted therapy