Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization

Abstract

Aim: This study aims to assess the clinicopathological characteristics, treatment patterns, and survival outcomes of geriatric patients with stage II-III colorectal cancer. Material and Methods: This retrospective study included 99 geriatric patients (aged ≥65 years) diagnosed with stage II-III colorectal cancer at a single center from 2020 to 2024. Clinical and pathological characteristics, treatment approaches, and survival outcomes were assessed. Results: The median age at diagnosis was 73 years, and 63.6% of patients were male. Adjuvant chemotherapy was administered to 86.9% of patients, with a significantly higher rate in stage III cases compared to stage II (91.3% vs. 58.5%, p < 0.001). Capecitabine-based therapy was the most frequently used chemotherapy regimen. Surgical resection achieved negative margins in 97.9% of cases, with right hemicolectomy being the most frequently performed procedure (54.5%). The median recurrence-free survival (RFS) was 20 months, and recurrence or metastasis occurred in 20.2% of patients, with the liver being the most frequent metastatic site. Treatment-related toxicity was observed in 53.5% of patients, leading to chemotherapy discontinuation in six cases. Conclusion: Adjuvant chemotherapy was more frequently administered in stage III patients, in line with current treatment guidelines. Differences in chemotherapy regimens between stage II and III patients underscore the importance of personalized treatment strategies in the geriatric population. Further research is required to optimize treatment decisions and improve clinical outcomes in this vulnerable group. Keywords: colon cancer, colorectal cancer, geriatrics, adjuvant chemotherapy

Keywords

• colon cancer
• colorectal cancer
• geriatrics
• adjuvant chemotherapy

Ethical Statement

The study received ethical approval from Aksaray University ethics committee (number: 2025/54), and the study protocol was conducted in accordance with the 1964 Helsinki Declaration.

Geriyatrik hastalarda evre II-III kolorektal kanser: Klinikopatolojik özellikler ve kemoterapi kullanımı

Abstract

Amaç: Bu çalışma, evre II-III kolorektal kanser tanısı almış geriyatrik hastaların klinikopatolojik özelliklerini, tedavi yaklaşımlarını ve sağkalım sonuçlarını değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Bu retrospektif çalışmaya, 2020-2024 yılları arasında tek bir merkezde evre II-III kolorektal kanser tanısı almış ve yaşı ≥65 olan 99 geriyatrik hasta dahil edilmiştir. Klinik ve patolojik özellikler, tedavi yaklaşımları ve sağkalım sonuçları değerlendirilmiştir. Bulgular: Tanı anındaki medyan yaş 73 yıl olup, hastaların %63,6’sı erkekti. Adjuvan kemoterapi, hastaların %86,9’una uygulanmış olup, evre III hastalarda evre II hastalara kıyasla belirgin şekilde daha yüksek oranda uygulanmıştır (sırasıyla %91,3 ve %58,5, p < 0,001). En sık kullanılan kemoterapi rejimi kapesitabin bazlı tedaviydi. Cerrahi rezeksiyon yapılan hastaların %97,9’unda negatif cerrahi sınır elde edilmiş, en sık uygulanan prosedür sağ hemikolektomi (%54,5) olmuştur. Medyan nükssüz sağkalım (RFS) süresi 20 ay olup, hastaların %20,2’sinde nüks veya metastaz gelişmiş, en sık karaciğer metastazı gözlenmiştir. Tedaviye bağlı toksisite %53,5 oranında rapor edilmiş olup, altı hastada ciddi yan etkiler nedeniyle kemoterapi bırakılmıştır. Sonuç: Adjuvan kemoterapi, evre III hastalara daha sık uygulanmış ve bu durum mevcut tedavi kılavuzları ile uyumludur. Evre II ve III hastalar arasındaki kemoterapi rejimi farklılıkları, geriyatrik popülasyonda kişiselleştirilmiş tedavi stratejilerinin önemini vurgulamaktadır. Bu hassas hasta grubunda tedavi kararlarını optimize etmek ve klinik sonuçları iyileştirmek için daha fazla araştırmaya ihtiyaç vardır.

Keywords

• kolon kanseri
• kolorektal kanser
• geriatri
• adjuvan kemoterapi

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