Colorectal cancer care in elderly patients: Unsolved issues

Dig Liver Dis. 2016 Oct;48(10):1112-8. doi: 10.1016/j.dld.2016.05.011. Epub 2016 May 19.

Abstract

Colorectal cancers are common in elderly patients. However, cancer screening is poorly used after 75. Elderly patients form a heterogeneous population with specific characteristics. Standards of care cannot therefore be transposed from young to elderly patients. Tumour resection is frequently performed but adjuvant chemotherapy is rarely prescribed as there are no clearly established standards of care. In a metastatic setting, recent phase III studies have demonstrated that doublet front-line chemotherapy provided no survival benefit. Moreover, several studies have established the benefit of bevacizumab in association with chemotherapy. There is a lack of evidence for the efficacy of anti-epidermal growth factor antibodies in elderly patients. Geriatric assessments could help to select the adequate treatment strategy for individual patients. Geriatric oncology is now the challenge we have to face, and more specific trials are needed.

Keywords: Adjuvant therapy; Chemotherapy; Geriatric oncology; Radiotherapy; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab / therapeutic use
  • Chemotherapy, Adjuvant / methods
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / therapy*
  • Disease-Free Survival
  • Geriatric Assessment
  • Humans
  • Mass Screening
  • Molecular Targeted Therapy / methods
  • Radiotherapy / methods
  • Randomized Controlled Trials as Topic

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab