nach oben

Current Geriatrics Reports

Erschienen in:

01.09.2014 | Geriatric Oncology (TM Wildes, Section Editor)

Colon Cancer in Older Adults: A Primer for Geriatricians

verfasst von: Tina Hsu, Efrat Dotan

Erschienen in: Current Geriatrics Reports | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Colon cancer is one of the most common malignancies affecting older adults. Studies suggest that older adults are less likely to receive standard treatments, such as curative surgery or chemotherapy, compared to their younger counterparts, despite evidence suggesting that fit older adults derive equal benefit. The patient’s overall health, life expectancy from non-cancer conditions, and personal preferences are important considerations in decisions with regard to colon cancer screening and management of early-stage or metastatic disease. Geriatricians can help oncologists better understand an older adult’s overall health and life expectancy from a non-cancer point of view and can help elucidate patient goals of care, advocating for screening and chemotherapy in those who are healthy enough, and helping to prioritize goals of care when patients have other life-limiting illnesses that may preclude cancer treatment. This manuscript will attempt to provide practicing geriatricians with evidence-based data regarding the management of colon cancer in older adults.

1.•

Jemal A, Siegel R, Xu J, Ward E. Cancer statistics. CA Cancer J Clin. 2010;60(5):277–300.PubMedCrossRef

Gundrum JD, Go RS. Cancer in the oldest old in the United States: Current statistics and projections. J Geriatr Oncol. 2012;3:299–306.CrossRef

Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, et al. Prevention of colorectal cancer by colonoscopic polypectomy. Nat Polyp Study Workgroup New Engl J Med. 1993;329(27):1977–81.CrossRef

United States Preventative Services Task Force. Screening for Colorectal Cancer. 2008 [updated 2008; cited 2014 March 13, 2014]; Available from: http://www.uspreventiveservicestaskforce.org/uspstf/uspscolo.htm.

American Cancer Society. American Cancer Society recommendations for colorectal cancer early detection. 2014 [updated 2014 January 31, 2014; cited 2014 April 10, 2014]; Available from: http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations.

Canadian Cancer Society. Screening for colorectal cancer. 2014 [updated 2014 2014; cited 2014 April 10, 2014]; Available from: http://www.cancer.ca/en/prevention-and-screening/early-detection-and-screening/screening/screening-for-colorectal-cancer/?region=pe.

7.••

Ko CW, Sonnenberg A. Comparing risks and benefits of colorectal cancer screening in elderly patients. Gastroenterology. 2005;129(4):1163–70. Models risk and benefits of screening based on patient age, health, and screening strategy utilized.PubMedCrossRef

8.•

Lin OS, Kozarek RA, Schembre DB, Ayub K, Gluck M, Drennan F, et al. Screening colonoscopy in very elderly patients: prevalence of neoplasia and estimated impact on life expectancy. JAMA. 2006;295(20):2357–65. Cross-sectional study comparing potential benefits of screening colonoscopy in patients based on age and life expectancy.PubMedCrossRef

Warren JL, Klabunde CN, Mariotto AB, Meekins A, Topor M, Brown ML, et al. Adverse Events After Outpatient Colonoscopy in the Medicare Population. Ann Intern Med. 2009;150(12):849–57.PubMedCrossRef

10.••

Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA. 2001;285(21):2750–6. Provides an approach to weighing risks and benefits of cancer screening in older adults. Includes life expectancy graphs based on age and overall health.PubMedCrossRef

11.

Mandel JS, Church TR, Bond JH, Ederer F, Geisser MS, Mongin SJ, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med. 2000;343(22):1603–7.PubMedCrossRef

12.

Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996;348(9040):1467–71.PubMedCrossRef

13.

Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen CM, et al. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report. Ann Intern Med. 1995;122(5):321–6.PubMedCrossRef

14.

O'Connell MJ, Mailliard JA, Kahn MJ, Macdonald JS, Haller DG, Mayer RJ, et al. Controlled trial of fluorouracil and low-dose leucovorin given for 6 months as postoperative adjuvant therapy for colon cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 1997;15(1):246–50.

15.

Ong ES, Alassas M, Dunn KB, Rajput A. Colorectal cancer surgery in the elderly: acceptable morbidity? Am J Surg. 2008;195(3):344–8. discussion 8.PubMedCrossRef

16.

Schiffmann L, Ozcan S, Schwarz F, Lange J, Prall F, Klar E. Colorectal cancer in the elderly: surgical treatment and long-term survival. Int J Colorectal Dis. 2008;23(6):601–10.PubMedCrossRef

17.

Gurevitch AJ, Davidovitch B, Kashtan H. Outcome of right colectomy for cancer in octogenarians. J Gastrointest Surg. 2009;13(1):100–4.PubMedCrossRef

18.••

Surgery for colorectal cancer in elderly patients: a systematic review. Colorectal Cancer Collaborative Group. Lancet. 2000;356(9234):968–74. This manuscript exentsive systematic review reports the disparity in use of curative surgery among older colon cancer patients.CrossRef

19.•

Jafari MD, Jafari F, Halabi WJ, Nguyen VQ, Pigazzi A, Carmichael JC, et al. Colorectal Cancer Resections in the Aging US Population: A Trend Toward Decreasing Rates and Improved Outcomes. JAMA Surg. 2014 This study reports the improvement in surgical outcomes among older colorectal cancer patients, with the greatest improvement seen among patients 85 years or older.

20.

Al-Refaie WB, Parsons HM, Habermann EB, Kwaan M, Spencer MP, Henderson WG, et al. Operative outcomes beyond 30-day mortality: colorectal cancer surgery in oldest old. Ann Surg. 2011;253(5):947–52.PubMedCrossRef

21.

Grosso G, Biondi A, Marventano S, Mistretta A, Calabrese G, Basile F. Major postoperative complications and survival for colon cancer elderly patients. BMC Surg. 2012;12:Suppl 1–S20.CrossRef

22.

Ihedioha U, Gravante G, Lloyd G, Sangal S, Sorge R, Singh B, et al. Curative colorectal resections in patients aged 80 years and older: clinical characteristics, morbidity, mortality and risk factors. Int J Colorectal Dis. 2013;28(7):941–7.PubMedCrossRef

23.

Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM. Safety and advantages of laparoscopic vs open colectomy in the elderly: matched-control study. Dis Colon Rectum. 2000;43(3):326–32.PubMedCrossRef

24.

Pope D, Ramesh H, Gennari R, Corsini G, Maffezzini M, Hoekstra HJ, et al. Pre-operative assessment of cancer in the elderly (PACE): a comprehensive assessment of underlying characteristics of elderly cancer patients prior to elective surgery. Surg Oncol. 2006;15(4):189–97.PubMedCrossRef

25.

Quasar CG. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007;370(9604):2020–9.CrossRef

26.

O'Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Natl Cancer Inst. 2004;96(19):1420–5.PubMedCrossRef

27.

Gill S, Loprinzi CL, Sargent DJ, Thom SD, Alberts SR, Haller DG, et al. Pooled Analysis of Fluorouracil-Based Adjuvant Therapy for Stage II and III Colon Cancer: Who Benefits and by How Much? J Clin Oncol. 2004;22(10):1797–806.PubMedCrossRef

28.

Andre T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol: Off J Am Soc Clin Oncol. 2009;27(19):3109–16.CrossRef

29.

Kuebler JP, Wieand HS, O'Connell MJ, Smith RE, Colangelo LH, Yothers G, et al. Oxaliplatin combined with weekly bolus fluorouracil and leucovorin as surgical adjuvant chemotherapy for stage II and III colon cancer: results from NSABP C-07. J Clin Oncol: Off J Am Soc Clin Oncol. 2007;25(16):2198–204.CrossRef

30.

Figueredo A, Coombes ME, Mukherjee S. Adjuvant therapy for completely resected stage II colon cancer. Cochrane Database of Syst Rev. 2008;3, CD005390.

31.

International Multi Centre Pooled Analysis of B2 Colon Cancer Trials Investigators. Efficacy of Adjuvant Fluorouracil and Folinic Acid in B2 Colon Cancer. J Clin Oncol. 1999;17(5):1356.

32.

Gray R, Barnwell J, McConkey C, Hills RK, Williams NS, Kerr DJ. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007;370(9604):2020–9.PubMedCrossRef

33.••

Goldberg RM, Tabah-Fisch I, Bleiberg H, de Gramont A, Tournigand C, Andre T, et al. Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2006;24(25):4085-91 This pooled analysis provides data regarding the use of 5FU in combination with oxaliplatin among older colon cancer patients.

34.••

Sargent DJ, Goldberg RM, Jacobson SD, Macdonald JS, Labianca R, Haller DG, et al. A Pooled Analysis of Adjuvant Chemotherapy for Resected Colon Cancer in Elderly Patients. New England Journal of Medicine. 2001;345(15):1091-7 This is a pooled analysis evaluating the adjuvant chemotherapy outcomes among older colon cancer patients.

35.••

Hamza S, Bouvier AM, Rollot F, Lepage C, Faivre J, Bedenne L. Toxicity of Oxaliplatin Plus Fluorouracil/Leucovorin Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer: A Population-Based Study. Annals of surgical oncology. 2014 This is a population-based study evaluating the toxicity associated with oxaliplatin and 5FU chemotherapy in the adjuvant setting among older patients.

36.

Kahn KL, Adams JL, Weeks JC, Chrischilles EA, Schrag D, Ayanian JZ, et al. Adjuvant chemotherapy use and adverse events among older patients with stage III colon cancer. Jama. 2010;303(11):1037-45. PMCID: 2893553.

37.

Meyer CC, Calis KA, Burke LB, Walawander CA, Grasela TH. Symptomatic cardiotoxicity associated with 5-fluorouracil. Pharmacotherapy. 1997;17(4):729–36.PubMed

38.

de Forni M, Malet-Martino MC, Jaillais P, Shubinski RE, Bachaud JM, Lemaire L, et al. Cardiotoxicity of high-dose continuous infusion fluorouracil: a prospective clinical study. J Clinical Oncol: Off J Am Soc Clin Oncol. 1992;10(11):1795–801.

39.

Labianca R, Beretta G, Clerici M, Fraschini P, Luporini G. Cardiac toxicity of 5-fluorouracil: a study on 1083 patients. Tumori. 1982;68(6):505–10.PubMed

40.

Wacker A, Lersch C, Scherpinski U, Reindl L, Seyfarth M. High incidence of angina pectoris in patients treated with 5-fluorouracil. A planned surveillance study with 102 patients. Oncology. 2003;65(2):108–12.PubMedCrossRef

41.

Akhtar SS, Salim KP, Bano ZA. Symptomatic cardiotoxicity with high-dose 5-fluorouracil infusion: a prospective study. Oncology. 1993;50(6):441–4.PubMedCrossRef

42.

Jensen SA, Sorensen JB. Risk factors and prevention of cardiotoxicity induced by 5-fluorouracil or capecitabine. Cancer Chemother Pharmacol. 2006;58(4):487–93.PubMedCrossRef

43.•

Tofthagen C, Overcash J, Kip K. Falls in persons with chemotherapy-induced peripheral neuropathy. Support Care Cancer: Off J Multinatl Assoc Support Care Cancer. 2012;20(3):583–9. This manuscripts describes the association between chemotherapy induced peripheral neuropathy and falls among older cancer patients.CrossRef

44.••

McCleary NJ, Meyerhardt JA, Green E, Yothers G, de Gramont A, Van Cutsem E, et al. Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database. J Clin Oncol: Off J Am Soc Clin Oncol. 2013;31(20):2600–6. This study evaluated the benefit of the addition of oxaliplatin to 5FU chemotherapy following resection of early stage colon cancer among older patients. The benefit seen with the addition of oxaliplatin to 5FU in younger patients was not reproduced in the older patient population.CrossRef

45.••

Sanoff HK, Carpenter WR, Sturmer T, Goldberg RM, Martin CF, Fine JP, et al. Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol: Off J Am Soc Clin Oncol. 2012;30(21):2624–34. PMCID: 3412313 This large retrospective study reports limited benefit with the addition of oxaliplatin to 5FU chemotherapy in the adjuvant setting among older colon cancer patients.CrossRef

46.

Schrag D, Cramer LD, Bach PB, Begg CB. Age and adjuvant chemotherapy use after surgery for stage III colon cancer. J Natl Cancer Inst. 2001;93(11):850–7.PubMedCrossRef

47.

Jorgensen ML, Young JM, Dobbins TA, Solomon MJ. Does patient age still affect receipt of adjuvant therapy for colorectal cancer in New South Wales, Australia? Journal of geriatric oncology. 2014.

48.

Rayson D, Urquhart R, Cox M, Grunfeld E, Porter G. Adherence to clinical practice guidelines for adjuvant chemotherapy for colorectal cancer in a Canadian province: a population-based analysis. J Oncol Pract / Am Soc Clin Oncol. 2012;8(4):253–9.CrossRef

49.

Sargent DJ, Wieand HS, Haller DG, Gray R, Benedetti JK, Buyse M, et al. Disease-Free Survival Versus Overall Survival As a Primary End Point for Adjuvant Colon Cancer Studies: Individual Patient Data From 20,898 Patients on 18 Randomized Trials. J Clin Oncol. 2005;23(34):8664–70.PubMedCrossRef

50.

Meulenbeld HJ, van Steenbergen LN, Janssen-Heijnen ML, Lemmens VE, Creemers GJ. Significant improvement in survival of patients presenting with metastatic colon cancer in the south of The Netherlands from 1990 to 2004. Ann Oncol: Off J Eur Soc Med Oncol / ESMO. 2008;19(9):1600–4.CrossRef

51.

de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 2000;18(16):2938–47.

52.

Douillard JY, Siena S, Cassidy J, Tabernero J, Burkes R, Barugel M, et al. Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study. J Clin Oncol: Off J Am Soc Clin Oncol. 2010;28(31):4697–705.CrossRef

53.

Goldberg RM, Sargent DJ, Morton RF, Fuchs CS, Ramanathan RK, Williamson SK, et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 2004;22(1):23–30.CrossRef

54.

Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004;350(23):2335–42.PubMedCrossRef

55.

Van Cutsem E, Kohne CH, Hitre E, Zaluski J, Chang Chien CR, Makhson A, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–17.PubMedCrossRef

56.

Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore MJ, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group New Engl J Med. 2000;343(13):905–14.CrossRef

57.••

Seymour MT, Thompson LC, Wasan HS, Middleton G, Brewster AE, Shepherd SF, et al. Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial. Lancet. 2011;377(9779):1749–59. Elderly specific prospective clinical trial randomizing older/frail patients between single agent 5FU/Capecitabine versus in combination with dose reduced oxaliplatin.PubMedCentralPubMedCrossRef

58.••

Cunningham D, Lang I, Marcuello E, Lorusso V, Ocvirk J, Shin DB, et al. Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial. Lancet Oncol. 2013;14(11):1077–85. This elderly specific prospective randomized clinical trial demonstrated significant improvement in outcomes with the addition of bevacizumab to capecitabine in the front line setting of metastatic colon cancer among older patients.PubMedCrossRef

59.

Balducci L. Supportive care of elderly patients with cancer. Support Cancer Ther. 2005;2(4):225–8.PubMedCrossRef

60.•

Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L, et al. Liver resection of colorectal metastases in elderly patients. Br J Surg. 2010;97(3):366–76. This study provides important information regarding the outcomes of older patients undergoing surgical resection of colon cancer metastases.PubMedCrossRef

61.•

Robertson DJ, Stukel TA, Gottlieb DJ, Sutherland JM, Fisher ES. Survival after hepatic resection of colorectal cancer metastases: a national experience. Cancer. 2009;115(4):752–9. This study provides important information regarding the outcomes of older patients undergoing surgical resection of colon cancer metastases.PubMedCentralPubMedCrossRef

62.

Hess GP, Wang PF, Quach D, Barber B, Zhao Z. Systemic Therapy for Metastatic Colorectal Cancer: Patterns of Chemotherapy and Biologic Therapy Use in US Medical Oncology Practice. J Oncol Pract / Am Soc Clin Oncol. 2010;6(6):301–7.CrossRef

63.

Abrams TA, Meyer G, Schrag D, Meyerhardt JA, Moloney J, Fuchs CS. Chemotherapy usage patterns in a US-wide cohort of patients with metastatic colorectal cancer. J Natl Cancer Inst. 2014;106(2):djt371.PubMedCrossRef

64.

Maindrault-Goebel F, Lledo G, Chibaudel B, Mineur L, Andre T, Bennamoun M, et al. Final results of OPTIMOX2, a large randomized phase II study of maintenance therapy or chemotherapy-free intervals (CFI) after FOLFOX in patients with metastatic colorectal cancer (MRC): A GERCOR study. Journal of Clinical Oncology, ASCO Annual Meeting Proceedings Part I 2007;Vol 25( No. 18S (June 20 Supplement)):Abstract # : 4013

65.••

Folprecht G, Cunningham D, Ross P, Glimelius B, Di Costanzo F, Wils J, et al. Efficacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials. Ann Oncol: Off J Eur Soc Med Oncol / ESMO. 2004;15(9):1330–8. This pooled analysis supports the use of 5FU based chemotherapy among older patients with metastatic colon cancer.CrossRef

66.••

Feliu J, Salud A, Escudero P, Lopez-Gomez L, Bolanos M, Galan A, et al. XELOX (capecitabine plus oxaliplatin) as first-line treatment for elderly patients over 70 years of age with advanced colorectal cancer. British journal of cancer. Br J Cancer. 2006;94(7):969–75. This study demonstrates the benefit of the combination of capecitabine and oxaliplatin for first line therapy of patients over the age of 70 with metastatic colon cancer.PubMedCentralPubMedCrossRef

67.

Twelves CJ, Butts CA, Cassidy J, Conroy T, Braud F, Diaz-Rubio E, et al. Capecitabine/oxaliplatin, a safe and active first-line regimen for older patients with metastatic colorectal cancer: post hoc analysis of a large phase II study. Clin Colorectal Cancer. 2005;5(2):101–7.PubMedCrossRef

68.••

Van Cutsem E, Rivera F, Berry S, Cunningham D. Safety and efficacy of bevacizumab (BEV) and chemotherapy in elderly patients with metastatic colorectal cancer (MCRC): Results from the BEAT observational cohort study. Ann Oncol: Off J Eur Soc Med Oncol / ESMO. 2009;20 Suppl 7:PD-0005. This is a report of the tolerance and benefit of bevacizumab among older mCC patients from the BEAT observational cohort study.

69.

Hershman DL, Wright JD, Lim E, Buono DL, Tsai WY, Neugut AI. Contraindicated use of bevacizumab and toxicity in elderly patients with cancer. J Clin Oncol. 2013;31(28):3592–9.PubMedCrossRef

70.••

Souglakos J, Pallis A, Kakolyris S, Mavroudis D, Androulakis N, Kouroussis C, et al. Combination of irinotecan (CPT-11) plus 5-fluorouracil and leucovorin (FOLFIRI regimen) as first line treatment for elderly patients with metastatic colorectal cancer: a phase II trial. Oncology. 2005;69(5):384–90. The study reports the outcomes and toxicity of the use of combination chemotherapy with 5FU and irinotecan among older patients with metastatic colon cancer.PubMedCrossRef

71.•

Bouchahahda M, Macarulla T, Spano JP, Bachet JB, Liedo G, Andre T, et al. Cetuximab and irinotecan-baed chemotherapy as an active and safe treatment option for elderly patients with extensively pre-treated metastatic colorecatl cancer. . Journal of Clinical Oncology, ASCO Annual Meeting Proceedings Part I. 2007;25(18S):Abstract #14528 Retrospective report evaluating older patient's tolerance to anti Epidermal Growth Factro Recpetor agents for treatment of mCC.

72.••

Kozloff M, Sugrue MM, Berlin J, Flynn PJ, Kabbinavar F, Sargent D, et al. Safety and effectiveness of bevacizumab (BV) and chemotherapy (CT) in elderly patients (pts) with metastatic colorectal cancer (mCRC): Results from the BRiTE Prospective Cohort Study. 2008 Gastrointestinal Cancers Symposium.Abstract 454 This is a report of the tolerance and benefit of adding bevacizumab to chemotherapy among older mCC patients, dat from teh BRiTE prospective cohort study.

73.

Bouchahda M, Macarulla T, Spano JP, Bachet JB, Lledo G, Andre T, et al. Cetuximab efficacy and safety in a retrospective cohort of elderly patients with heavily pretreated metastatic colorectal cancer. Crit Rev Oncol/Hematol. 2008;67(3):255–62.CrossRef

74.

75.

Gravalos C, Rivera F, massuti B, Sastre J, Marcuello E, Valladares M, et al. Cetuximab and capecitabine as first-line treatment for elderly patients with metastatic colorectal cancer: Preliminary results of TTD trial. Journal of Clinical Oncology, ASCO Annual Meeting Proceedings Part I. 2008(20S):Abstract # 15027.

76.

Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381(9863):303–12.PubMedCrossRef

77.

Tabernero J, Van Cutsem E, Lakomy R, Prausova J, Ruff P, van Hazel GA, et al. Aflibercept versus placebo in combination with fluorouracil, leucovorin and irinotecan in the treatment of previously treated metastatic colorectal cancer: Prespecified subgroup analyses from the VELOUR trial. European journal of cancer. 2013.

78.••

Aparicio T, Jouve JL, Teillet L, Gargot D, Subtil F, Le Brun-Ly V, et al. Geriatric factors predict chemotherapy feasibility: ancillary results of FFCD 2001-02 phase III study in first-line chemotherapy for metastatic colorectal cancer in elderly patients. J Clin Oncol: Off J Am Soc Clin Oncol. 2013;31(11):1464–70. This study evaluated the ability of factors evaluated in the geriatric assessment to predict for treatment toxicity. The study found that patients with cognative impairment and ADL dependancy were more likely to experience chemotherapy toxicity.CrossRef

79.

Ho C, Ng K, O'Reilly S, Gill S. Outcomes in elderly patients with advanced colorectal cancer treated with capecitabine: a population-based analysis. Clin Colorectal Cancer. 2005;5(4):279–82.PubMedCrossRef

80.

Pasetto LM, Falci C, Sinigaglia G, Brandes AA, Monfardini S. How many colorectal cancer (CRC) patients older than 70 years may be safely treated with bevacizumab? Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2006;24(18S):Abstract # 13589.

81.

Fried TR, Bradley EH, Towle VR, Allore H. Understanding the treatment preferences of seriously ill patients. N Engl J Med. 2002;346(14):1061–6.PubMedCrossRef

82.

Aaldriks AA, van der Geest LG, Giltay EJ, le Cessie S, Portielje JE, Tanis BC, et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol. 2013;4(3):218–26.PubMedCrossRef

83.

Giantin V, Valentini E, Iasevoli M, Falci C, Siviero P, De Luca E, et al. Does the Multidimensional Prognostic Index (MPI), based on a Comprehensive Geriatric Assessment (CGA), predict mortality in cancer patients? Results of a prospective observational trial. J Geriatr Oncol. 2013;4(3):208–17.PubMedCrossRef

84.

Extermann M, Boler I, Reich RR, Lyman GH, Brown RH, DeFelice J, et al. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 2012;118(13):3377–86.PubMedCrossRef

85.••

Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29(25):3457–65. This study reports a novel model using the geriatric assessment for prediction of chemotherapy associated toxicity among older cancer patients.PubMedCentralPubMedCrossRef

86.

Extermann M, Meyer J, McGinnis M, Crocker TT, Corcoran MB, Yoder J, et al. A comprehensive geriatric intervention detects multiple problems in older breast cancer patients. Crit Rev Oncol/Hematol. 2004;49(1):69–75.CrossRef

87.

Kenis C, Bron D, Libert Y, Decoster L, Van Puyvelde K, Scalliet P, et al. Relevance of a systematic geriatric screening and assessment in older patients with cancer: results of a prospective multicentric study. Ann Oncol: Off J Eur Soc Med Oncol / ESMO. 2013;24(5):1306–12.CrossRef

Titel: Colon Cancer in Older Adults: A Primer for Geriatricians
verfasst von: Tina Hsu
Efrat Dotan
Publikationsdatum: 01.09.2014
Verlag: Springer US
Erschienen in: Current Geriatrics Reports / Ausgabe 3/2014
Elektronische ISSN: 2196-7865
DOI: https://doi.org/10.1007/s13670-014-0087-4

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Alphablocker schützt vor Miktionsproblemen nach der Biopsie

16.05.2024 alpha-1-Rezeptorantagonisten Nachrichten

Nach einer Prostatabiopsie treten häufig Probleme beim Wasserlassen auf. Ob sich das durch den periinterventionellen Einsatz von Alphablockern verhindern lässt, haben australische Mediziner im Zuge einer Metaanalyse untersucht.

Eingreifen von Umstehenden rettet vor Erstickungstod!

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Neue S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Schadet Ärger den Gefäßen?

14.05.2024 Arteriosklerose Nachrichten

In einer Studie aus New York wirkte sich Ärger kurzfristig deutlich negativ auf die Endothelfunktion gesunder Probanden aus. Möglicherweise hat dies Einfluss auf die kardiovaskuläre Gesundheit.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2014

Multiple Myeloma in Older Adults

Rehabilitation Considerations for the Older Adult with Heart Failure: A Review of the Literature

The Relationship Between the Physical Functioning of Older Adults and Their Use of a Personal Health Record: A Systematic Review

Falls in Older Adults with Cancer

Endometrial Cancer in the Elderly