Adjuvant chemotherapy in elderly patients (≥75 yr) completely resected for colon cancer stage III compared to younger patients

Søren Astrup Jensen1 , Adam Vilmar1 and Jens Benn Sørensen1

(1) Department of Oncology 5073, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

Received: 15 January 2006 Accepted: 28 March 2006

Abstract
Purpose To compare benefits and risks to adjuvant chemotherapy following complete resection of nodepositive colon cancer stage III for patients aged ≥75 yr and younger.
Method A retrospective study compared recurrence-free and overall survival, toxicity, and dose intensity of adjuvant bolus 5-FU according to the Mayo regimen chemotherapy in consecutive patients aged 19–74 (n=203) and ≥75 yr (n=24).
Results The estimated 5-yr proportional survival rates were 0.65 for patients age less than 75 yr compared to 0.65 (p=0.96) for elderly. The frequencies of anemia (0%), thrombocytopenia (0%), leukopenia (4%), infection *8%), vomiting (0%), mucositis (17%), diarrhea (13%) CTC grade 3 or 4 toxicity in elderly patients were not significantly different from that in younger patients (p>0.05). Significantly more elderly (8%) had a decline in performance status to grade 3 or 4, as compared to younger patients (4%) (p=0.002). 5-FU dose reduction was necessary for significantly more elderly (51%) as compared to younger patients (28%) (p=0.02), and fewer elderly (54%) completed the scheduled six treatment courses as compared to younger patients (82%) (p=0.05).
Conclusions Adjuvant 5-FU chemotherapy should be considered for elderly patients aged ≥75 yr in good performance at high risk of recurrence of colon carcinoma after resection.
Key Words Colonic neoplasms - chemotherapy - adjuvant - fluorouracil - aged - disease-free survival - adverse effects