Elderly with Colon Cancer Benefit from Adjuvant Chemotherapy
In this study, the investigators aimed to determine the benefits (if any) of administering adjuvant chemotherapy for stage III colon cancer (CC) in patients aged 75 years and older. Trial enrollees (N=5,489) who were ≥ 75 years of age with resected stage III CC were selected from four data sets including SEER-Medicare, a linkage between the New York State Cancer Registry (NYSCR) and its Medicare programs, and prospective cohort studies Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) and the National Comprehensive Cancer Network.
The investigators reported the following results. “Chemotherapy receipt was associated with a survival benefit of comparable magnitude to clinical trials results (SEER-Medicare PS-matched mortality, hazard ratio [HR], 0.60; 95% CI, 0.53–0.68),” they wrote. “The incremental benefit of oxaliplatin over non-oxaliplatin-containing regimens was also of similar magnitude to clinical trial results (SEER-Medicare, HR, 0.84; 95% CI, 0.69–1.04; NYSCR-Medicare, HR, 0.82, 95% CI, 0.51–1.33) in 2 of 3 examined data sources; statistical significance was inconsistent.”
The investigators made the following conclusions. “Patients with stage III CC ≥ 75 years of age may anticipate a survival benefit from adjuvant chemotherapy, oxaliplatin offers no more than a small incremental benefit, and use of adjuvant chemotherapy after the age of 75 years merits consideration in discussions that weigh individual risks and preferences.”