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Review
. 2018 Mar 11:2018:2176056.
doi: 10.1155/2018/2176056. eCollection 2018.

Treatment of Elderly Patients with Colorectal Cancer

Yoshiro Itatani  1 , Kenji Kawada  1 , Yoshiharu Sakai  1
Affiliations
Review

Treatment of Elderly Patients with Colorectal Cancer

Yoshiro Itatani et al. Biomed Res Int. .

Abstract

Colorectal cancer (CRC) is one of the leading causes of cancer-related deaths worldwide. As society ages, the number of elderly patients with CRC will increase. The percentage of patients with right-sided colon cancer and the incidence of microsatellite instability are higher in elderly than in younger patients with CRC. Moreover, the higher incidence of comorbid diseases in elderly patients indicates the need for less invasive treatment strategies. For example, care should be taken in performing additional surgery after endoscopic submucosal dissection for elderly patients with high-risk T1 CRC. Minimally invasive surgery, such as laparoscopic colectomy, would be preferable for elderly patients with CRC. Chemotherapy for elderly patients requires careful monitoring for adverse events. The aim of this review is to summarize the clinicopathological features of CRC in elderly patients, optical surgical strategies, including endoscopic and laparoscopic resection, and chemotherapeutic strategies, including postoperative adjuvant chemotherapy and systemic chemotherapy for unresectable CRC.

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Figures

Figure 1
Figure 1
(a) Proportion of tumor location at indicated ages [10]. (b) Proportion of pathological T factor at indicated ages [10]. (c) Proportion of lymph node metastases at indicated ages [10].
Figure 2
Figure 2
(a) Proportion of MMR-deficient CRC at indicated ages [12]. (b) Proportion of hMLH1 loss in CRC at indicated ages [13].
Figure 3
Figure 3
Schematic representation of the hypothesis of CRC carcinogenesis. Upper section shows serrated pathway, and lower one shows classical pathway.
See this image and copyright information in PMC

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