Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old
Abstract
:1. Introduction
2. Presentation, Characteristics, and Biology of Colorectal Cancer in Older Patients
3. Treatments of Colorectal Cancers in Octogenarians and Older Patients
3.1. Surgery
3.2. Chemotherapy
4. Survival Outcomes and Intensity of Therapy in Patients Older than 80 Years-Old
5. Prognostic Factors
6. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | N (>80 vs. <80) | Comparator Group | Mean Age (yr) | Comorbidities | Right Location | Grade 3 | Stage IV |
---|---|---|---|---|---|---|---|
Lee et al. [10] | 133 vs. 596 | 60–80 yo | 83.9 vs. 64.8 | 83.5% vs. 57% (p = 0.01) | 32.3% vs. 21.6% (p = 0.23) | 9.8% vs. 7.4% (p = 0.18) | NA |
Patel et al. [11] | 8643 vs. 24,176 | 65–80, 50–64, 18–49 | 85 vs. 42.3, 58 and 72.4 | NA | 65% vs. 49–58% | 23.4% vs. 19.4–25.5% | 15% vs. 16–24% |
Kotake et al. [12] | 3713 vs. 37,138 | 65–80, 50–64, 18–49 | NA | NA | 43% vs. 27.8% (p < 0.001) | 9.1% vs. 6.9% (p < 0.001) | 14.6% vs. 18% (p < 0.001) |
Sell et al. [13] | 329 vs. 972 | 50–79 | 85 vs. 66 (median | 63.7% vs. 59.5% (ASA class 3 or 4, p < 0.001) | 73.3% vs. 55.7% (p < 0.001) | NA | 6.1% vs. 17.9% (p < 0.001) |
Goldvaser et al. [14] | 175 vs. 175 | <80 | 83 vs. 63 | PS > 1: 29% vs. 6.1% (p < 0.001) | 45.7% vs. 34.3% (p = 0.029) | 89.3% vs. 80.7% (grade 2 and 3, p = 0.025) | 20% vs. 22% (p = 0.25) |
Study | Surgery | Chemotherapy | 30 Day Mortality | Survival |
---|---|---|---|---|
Lee et al. [10] | No difference in the number of retrieved lymph nodes | Lower rates of chemotherapy administration (adjuvant: 43.3% vs. 92.8%, p < 0.001, palliative: 35.8% vs. 89.4%, p = 0.01) | NA | OS and DFS decreased overall in the cohort and in stages II to IV |
Patel et al. [11] | No difference in the number of retrieved lymph nodes compared with patients 65–79 yo | Lower rates of chemotherapy 8% vs. 24% (65–80 yo), 38% (50–64 yo), and 48% (18–49 yo) | 9.3% vs. 4.5%, 3%, and 2.5% | Decreased OS and DSS stage by stage |
Kotake et al. [12] | Similar percentages of negative margins obtained | For stage III: 15.9% vs. 55.5% | NA | At 3 and 5 years, OS and CSS worse overall and stage by stage |
Sell et al. [13] | No difference in the number of retrieved lymph nodes | Neo-adjuvant: 0.9% vs. 6.8% (p < 0.001); adjuvant: 47.6% vs. 9.4% (p < 0.001) | 3.5% to 4.2% vs. 1.9% to 3.5% stratified according to tumor size (p = 0.49) | 3-year DFS: 63.8% vs. 59% (p = 0.12); Median OS: 4.4 years vs. 6.4 years (p < 0.001) |
Goldvaser et al. [14] | Surgery or other local interventions less likely (9.7% vs. 65.5%, p < 0.0001) | Neo-adjuvant or adjuvant chemotherapy: 27.5% vs. 60.9% (p < 0.0001); metastatic chemotherapy: 65.4% vs. 91.2% (p < 0.016) | NA | DFS: 68.7% vs. 78.7% (p = 0.15); 5-year OS: 38.55 vs. 74.8% (p < 0.0001); 5-year CSS: 63.4% vs. 77.6% (DFS: 68.7% vs. 78.7% (p = 0.15); 5-year OS: 38.55 vs. 74.8% (p < 0.009) |
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Voutsadakis, I.A. Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old. Medicina 2023, 59, 1574. https://doi.org/10.3390/medicina59091574
Voutsadakis IA. Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old. Medicina. 2023; 59(9):1574. https://doi.org/10.3390/medicina59091574
Chicago/Turabian StyleVoutsadakis, Ioannis A. 2023. "Presentation, Molecular Characteristics, Treatment, and Outcomes of Colorectal Cancer in Patients Older than 80 Years Old" Medicina 59, no. 9: 1574. https://doi.org/10.3390/medicina59091574