Adjuvant Chemotherapy Benefit in Elderly Stage II/III Colon Cancer Patients

Xin Chen; Junhao Tu; Xiaolan Xu; Wen Gu; Lei Qin; Haixin Qian; Zhenyu Jia; Chuntao Ma; Yinkai Xu

doi:10.3389/fonc.2022.874749

Adjuvant Chemotherapy Benefit in Elderly Stage II/III Colon Cancer Patients

Front Oncol. 2022 Jun 7:12:874749. doi: 10.3389/fonc.2022.874749. eCollection 2022.

Authors

Xin Chen¹, Junhao Tu², Xiaolan Xu³, Wen Gu¹, Lei Qin¹, Haixin Qian¹, Zhenyu Jia⁴, Chuntao Ma³, Yinkai Xu¹

Affiliations

¹ Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
² Department of General Surgery, Suzhou Wuzhong People's Hospital, Suzhou, China.
³ Department of Gastroenterology, Xiangcheng People's Hospital, Suzhou, China.
⁴ Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China.

Abstract

Background: Studies providing more evidence to guide adjuvant chemotherapy decisions in elderly colon cancer patients are expected.

Methods: We obtained data from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2012. Kaplan-Meier survival curves were constructed to calculate the cancer-specific survival (CSS) rate, and comparisons of survival difference between different subgroups were performed using the log-rank test. Multivariate Cox proportional hazards regression models were carried out to estimate hazard ratio (HR) and 95% confidence intervals (CIs) of different clinicopathological characteristics.

Results: In stage II colon cancer patients aged 70 years or older, the Kaplan-Meier survival analysis showed that the 5-year CSS rates of no chemotherapy and chemotherapy groups were 82.0% and 72.4%, respectively (P < 0.001). In stage III colon cancer patients aged 70 years or older, the Kaplan-Meier survival analysis showed that the 5-year CSS rates of no chemotherapy and chemotherapy groups were 50.7% and 61.3%, respectively (P < 0.001). Patients with chemotherapy receipt were independently associated with a 35.8% lower cancer-specific mortality rate (HR = 0.642, 95% CI: 0.620-0.665, P < 0.001) compared with those who did not receive chemotherapy.

Conclusions: Adjuvant chemotherapy should be considered during the treatment of stage III colon cancer patients aged 70 years or older, but the chemotherapy benefit in elderly stage II colon cancer is suboptimal.

Keywords: chemotherapy; colon cancer; elderly; stage II/III; survival.