Effect of oxaliplatin in elderly colon cancer patients with pathological T4 and/or N2 disease: a multicenter, propensity score-matched analysis.

Abstract

PURPOSE:

Although adjuvant chemotherapy (AC) using fluoro-pyrimidine and oxaliplatin (FU + oxaliplatin) is recommended after curative resection for locally advanced colon cancer patients, several randomized controlled trials have shown no additional effect of oxaliplatin in patients aged ≥ 70 years. Here, we examined the effectiveness of FU + oxaliplatin on the long-term outcome of old patients with a high risk of recurrence.

METHODS:

This multicenter, retrospective study included 346 colon cancer patients diagnosed with pathological T4 and/or N2 disease from 2016 to 2020. They were divided into an old group (≥ 70 years, n = 197) and a young group (< 70 years, n = 167). Propensity score matching was used to minimize selection bias, and 126 patients per group were matched.

RESULTS:

Before matching, the rates of poor performance status (p < 0.001) and the presence of comorbidities (76.1% vs. 47.9%, p < 0.001) were higher in the old group. Although all baseline factors were similar between groups, after matching, the AC rate was lower in the old group (45.2% vs. 65.1%, p = 0.002). In the old group, relapse-free (82.2% vs. 55.6% and 69.6%, p < 0.05) and overall survival (83.1% vs. 80.0% and 44.4%, p < 0.05) rates were significantly higher in the AC patients with FU + oxaliplatin than in the AC patients with only FU and the non-AC patients.

CONCLUSION:

The selected old colon cancer patients with a high risk of recurrence gained an additional benefit with respect to prognosis from FU + oxaliplatin as AC.

• Authors: Tetsuro Tominaga, Takashi Nonaka, Shosaburo Oyama, Toshio Shiraishi, Hiroaki Takeshita, Makoto Hisanaga, Hidetoshi Fukuoka, Akiko Fukuda, Yorihisa Sumida, Shintaro Hashimoto, Kazuo To, Kenji Tanaka, Terumitsu Sawai, Takeshi Nagayasu
• Journal: International journal of colorectal disease (Int J Colorectal Dis) Vol. 37 Issue 5 Pg. 1181-1188 (May 2022) ISSN: 1432-1262 [Electronic] Germany
• PMID: 35478036 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Oxaliplatin
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Chemotherapy, Adjuvant
• Colonic Neoplasms (drug therapy, pathology, surgery)
• Fluorouracil (therapeutic use)
• Humans
• Neoplasm Recurrence, Local (pathology)
• Neoplasm Staging
• Oxaliplatin (therapeutic use)
• Propensity Score
• Retrospective Studies