Multicenter Study

. 2021 Jul;26(7):1248-1256.

doi: 10.1007/s10147-021-01909-9. Epub 2021 Jun 5.

Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

Yujiro Nakayama^{1

2}, Hidetaka Kawamura^{3

4}, Michitaka Honda^{3

4}, Yoshinao Takano⁴, Koichi Takiguchi⁵, Takahiro Kamiga⁶, Shigeru Yamazaki⁷, Atsushi Muto⁸, Satoru Shiraso⁹, Naoyuki Yamashita¹⁰, Toshiyasu Iwao¹¹, Koji Kono¹², Shinichi Konno¹³

Affiliations

¹ Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Japan. nakayama.fd3s@gmail.com.
² Department of Surgery, Southern Tohoku General Hospital, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Kooriyama, Fukushima, Japan. nakayama.fd3s@gmail.com.
³ Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Japan.
⁴ Department of Surgery, Southern Tohoku General Hospital, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Kooriyama, Fukushima, Japan.
⁵ Department of Surgery, The Takeda Healthcare Foundation Takeda General Hospital, 3-27 Yamaga-machi, Aizuwakamatu-shi, Fukushima, Japan.
⁶ Department of Surgery, Shirakawa Kosei General Hospital, 2-1 Yajiro Toyochiji, Shirakawa, Fukushima, Japan.
⁷ Department of Surgery, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Kooriyama, Fukushima, Japan.
⁸ Department of Surgery, Fukushima Rosai Hospital, 3 Numajiri, Uchigou-Tsuzuramachi, Iwaki, Fukushima, Japan.
⁹ Department of Surgery, Iwaki Kyoritsu General Hospital, 16 Kusehara, Uchigou-Miyamamachi, Iwaki, Fukushima, Japan.
¹⁰ Department of Surgery, Tsuboi Hospital, 1-10-13 Nagakubo, Kooriyama, Fukushima, Japan.
¹¹ Department of Gastroenterology, Aidu Chuo Hospital, 1-1 Tsuruga-cho, Aizuwakamatu-shi, Fukushima, Japan.
¹² Department of Gastrointestinal Tract Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.
¹³ Department of Orthopedic Surgery, School Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.

PMID: 34089402
DOI: 10.1007/s10147-021-01909-9

Multicenter Study

Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

Yujiro Nakayama et al. Int J Clin Oncol. 2021 Jul.

. 2021 Jul;26(7):1248-1256.

doi: 10.1007/s10147-021-01909-9. Epub 2021 Jun 5.

Authors

Affiliations

¹ Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Japan. nakayama.fd3s@gmail.com.
² Department of Surgery, Southern Tohoku General Hospital, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Kooriyama, Fukushima, Japan. nakayama.fd3s@gmail.com.
³ Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 1, Hikarigaoka, Fukushima, Japan.
⁴ Department of Surgery, Southern Tohoku General Hospital, Southern Tohoku Research Institute for Neuroscience, 7-115 Yatsuyamada, Kooriyama, Fukushima, Japan.
⁵ Department of Surgery, The Takeda Healthcare Foundation Takeda General Hospital, 3-27 Yamaga-machi, Aizuwakamatu-shi, Fukushima, Japan.
⁶ Department of Surgery, Shirakawa Kosei General Hospital, 2-1 Yajiro Toyochiji, Shirakawa, Fukushima, Japan.
⁷ Department of Surgery, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Kooriyama, Fukushima, Japan.
⁸ Department of Surgery, Fukushima Rosai Hospital, 3 Numajiri, Uchigou-Tsuzuramachi, Iwaki, Fukushima, Japan.
⁹ Department of Surgery, Iwaki Kyoritsu General Hospital, 16 Kusehara, Uchigou-Miyamamachi, Iwaki, Fukushima, Japan.
¹⁰ Department of Surgery, Tsuboi Hospital, 1-10-13 Nagakubo, Kooriyama, Fukushima, Japan.
¹¹ Department of Gastroenterology, Aidu Chuo Hospital, 1-1 Tsuruga-cho, Aizuwakamatu-shi, Fukushima, Japan.
¹² Department of Gastrointestinal Tract Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.
¹³ Department of Orthopedic Surgery, School Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan.

PMID: 34089402
DOI: 10.1007/s10147-021-01909-9

Abstract

Background: It remains unclear whether intensive chemotherapy for Stage IV colorectal cancer (CRC) patients aged 80 years or older is beneficial prognostically. This study aimed to investigate the overall survival of Stage IV CRC patients aged ≥ 80 years receiving intensive chemotherapy.

Methods: The study design was a population-based, multicenter, historical cohort study. The extracted participants' data were consecutive patients diagnosed as Stage IV CRC between January 2008 and May 2015 in nine hospitals in Japan. Patients were classified into two groups according to age: aged group (≥ 80 years) and younger group (< 80 years old). Intensive chemotherapy was defined as at least two courses of doublet chemotherapy with oxaliplatin-or irinotecan-based regimens. The primary outcome was the adjusted hazard ratio (HR) of age ≥ 80 years in patients who undergoing intensive chemotherapy.

Results: During the study period, 1259 patients were treated for Stage IV CRC in the participating hospitals. In total, 231 patients (18.3%) were in the aged group, and 1028 (81.7%) were in the younger group, and 788 (62.6%) underwent intensive chemotherapy. The median overall survival for the aged and younger group patients was 21.0 months (interquartile range (IQR), 10.6-34.1 months) and 24.3 months (IQR 12.6-39.3 months), respectively. The adjusted HR of age ≥ 80 years was 1.29 (confidence intervals 0.84-2.00).

Conclusion: Stage IV CRC patients aged 80 years or older receiving intensive chemotherapy had a similar prognosis to those aged < 80 years. Avoiding intensive chemotherapy for mCRC patients simply because they are ≥ 80 years old is not recommended.

Keywords: Aged 80 and over; Chemotherapy; Colorectal cancer; Elderly patient.

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Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

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Benefit of intensive chemotherapy for elderly patients aged 80 years or older with metastatic colorectal cancer: a state-wide multicenter cohort study

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