Clinical Outcomes of Adjuvant Chemotherapy in Elderly Patients with Resected Stage II and III Colon Cancer: A Real Life Data

Öz

This study aimed to evaluate the efficacy and tolerability of adjuvant chemotherapy in clinical practice in the elderly patients with resected stage II and III colon cancer. Fifty-three resected stage II and III colon cancer patients respectively evaluated between August 2010 and September 2019 were included. The study population was divided into two group as received adjuvant chemotherapy and non-received group. Clinical features, overall survival (OS) and disease-free survival (DFS) were compared between groups. Cox regression analysis was used to determine independent risk factors for OS. The hazard ratio (HR) for OS in the group given adjuvant chemotherapy, as compared with non-received group, was 0.80 (95% Confidence interval [CI]: 0.66-0.90) (p=0.0025), corresponding to a 20 percent reduction in the risk of mortality. There was no statistically significant difference between the DFS of these groups (HR:1.02, 95% CI: 0.75-1,35) (p=0.96). In multivariate (age, perforation, obstruction, disease stage, adequate lymph node, tumor side) and univariate analysis, age was not an independent predictive marker for OS. Adjuvant chemotherapy was effective and its toxicity manageable for elderly patients both stage II and stage III colon cancer. Adjuvant chemotherapy decisions should be based on a biological age and functional assessment of the patient than chronological age.

Anahtar Kelimeler

• colon cancer
• adjuvant chemotherapy
• toxicity
• elderly patient.

Opere Evre II ve III Kolon Kanserli Yaşlı Hastalarda Adjuvan Kemoterapinin Klinik Sonuçları: Gerçek Yaşam Verileri

Öz

Bu çalışma, opere evre II ve III kolon kanserli yaşlı hastalarda adjuvan kemoterapinin klinik pratikteki etkinliğini ve tolere edilebilirliğini değerlendirmeyi amaçladı. Hasta popülasyonu adjuvan kemoterapi alan ve almayan grup olarak iki gruba ayrıldı. Gruplar arasında klinik özellikler, genel sağkalım (OS) ve hastalıksız sağkalım (DFS) karşılaştırıldı. OS için bağımsız risk faktörlerini belirlemek için Cox regresyon analizi kullanıldı. Adjuvan kemoterapi alan grup ile almayan arasında, OS için Hazard oranı (HR) 0.80 (%95 Güven aralığı [CI]: 0.66-0.90) (p=0.0025) tespit edildi. Bu grupların DFS'leri arasında istatistiksel olarak anlamlı bir fark yoktu (HR:1.02, %95 GA: 0.75-1,35) (p=0.96). Çok değişkenli analizde (yaş, perforasyon, obstrüksiyon, hastalık evresi, yeterli lenf nodu, tümör tarafı) ve tek değişkenli analizde yaş, OS için bağımsız bir prediktif belirteç değildi. Adjuvan kemoterapi hem evre II hem de evre III kolon kanserli yaşlı hastalarda etkiliydi ve toksisitesi yönetilebilirdi. Adjuvan kemoterapi kararı, kronolojik yaştan ziyade biyolojik yaşına ve hastanın fonksiyonel değerlendirmesine dayanmalıdır

Anahtar Kelimeler

• kolon kanseri
• adjuvan kemoterapi
• toksisite
• yaşlı hasta

Kaynakça

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