Adjuvant chemotherapy in patients with colorectal cancer. Is there a role in the older adult?

Eur J Surg Oncol. 2020 Mar;46(3):363-368. doi: 10.1016/j.ejso.2020.01.002. Epub 2020 Jan 8.

Abstract

As global life expectancy has increased in most countries, there is a rising percentage of patients over 65 years old being diagnosed with colorectal cancer. Despite an increase in the incidence and prevalence of colorectal cancer in older adults, this cohort receives adjuvant therapy at a decreased rate due to anticipated intolerance. The presumed limitations seem to be based on chronologic age, competing life limiting diagnoses, and the paucity of data studying this population in major clinical trials. This review explores the data regarding disparities in the treatment of older patients with colorectal cancer, safety and efficacy of adjuvant therapy, and newer tools to make decisions based on the biologic age, rather than chronologic age, of the patient.

Keywords: Adjuvant chemotherapy; Cancer in older adults; Colon cancer; Discrepancies in cancer care; Geriatric assessment tool; Rectal cancer.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / therapy*
  • Geriatric Assessment / methods*
  • Humans
  • Prognosis
  • Radiotherapy, Adjuvant