Stratified Survival Analysis After Adjuvant Chemotherapy of Colon Cancer Reveals a Benefit for Older Patients.

Abstract:

AIM:Adjuvant treatment is still controversially discussed for elderly colon cancer (CC) patients. Our aim was to investigate the benefit of adjuvant treatment for younger (<70 years) and elderly (≥70 years) patients. PATIENTS AND METHODS:The long-term outcome of patients (n=855) enrolled in a randomized controlled trial comparing adjuvant chemotherapy with 5-FU alone, 5-FU plus folinic acid (FA), and 5-FU plus interferon-alpha (IFNa) was compared in younger (<70 years) and elderly (≥70 years) patients using a quotient of each patient's survival time and his expected residual life expectancy (QSL) and a multivariate Cox proportional hazards model. RESULTS:Eight-year overall survival (OS) rates were 58.3% and 57.4% for younger (n=653) and elderly (n=202) patients, respectively. In elderly patients, 8-year OS rates were 51.4%, 61.8%, and 56.3, and median QSL scores were 0.338, 0.371, and 0.343 for 5-FU (n=59), 5-FU plus FA (n=76), and 5-FU plus IFNa (n=67), respectively. In elderly patients treatment with 5-FU plus FA decreased the risk for an event by 1.5-fold compared to 5-FU (HR=0.657, 95%CI=0.495-0.870, p=0.004) and 5-FU plus INFa (HR=0.685, 95%CI=0.515-0.912, p=0.009). CONCLUSION:Our analysis clearly demonstrates for the first time an additional benefit of FA for adjuvant treatment of elderly CC patients. We conclude that this regimen is very safe and effective for adjuvant treatment of elderly patients.

journal_name

Anticancer Res

journal_title

Anticancer research

authors

Mayer B,Sander S,Paschke S,Henne-Bruns D,Link KH,Kornmann M,Study Group Oncology of Gastrointestinal Tumors (FOGT).

subject

Has Abstract

pub_date

2015-10-01 00:00:00

pages

5587-93

issue

10

eissn

0250-7005

issn

1791-7530

pii

35/10/5587

journal_volume

35

pub_type

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