Benjamin Mayer1, Silvia Sander1, Stephan Paschke2, Doris Henne-Bruns2, Karl-Heinrich Link3, Marko Kornmann4. 1. Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany. 2. Department of General and Visceral Surgery, University of Ulm, Ulm, Germany. 3. Study Group Oncology of Gastrointestinal Tumors, Asklepios Paulinen Klinik, Wiesbaden, Germany. 4. Department of General and Visceral Surgery, University of Ulm, Ulm, Germany marko.kornmann@uniklinik-ulm.de.
Abstract
AIM: Adjuvant treatment is still controversially discussed for elderly colon cancer (CC) patients. Our aim was to investigate the benefit of adjuvant treatment for younger (<70 years) and elderly (≥70 years) patients. PATIENTS AND METHODS: The long-term outcome of patients (n=855) enrolled in a randomized controlled trial comparing adjuvant chemotherapy with 5-FU alone, 5-FU plus folinic acid (FA), and 5-FU plus interferon-alpha (IFNa) was compared in younger (<70 years) and elderly (≥70 years) patients using a quotient of each patient'ssurvival time and his expected residual life expectancy (QSL) and a multivariate Cox proportional hazards model. RESULTS: Eight-year overall survival (OS) rates were 58.3% and 57.4% for younger (n=653) and elderly (n=202) patients, respectively. In elderly patients, 8-year OS rates were 51.4%, 61.8%, and 56.3, and median QSL scores were 0.338, 0.371, and 0.343 for 5-FU (n=59), 5-FU plus FA (n=76), and 5-FU plus IFNa (n=67), respectively. In elderly patients treatment with 5-FU plus FA decreased the risk for an event by 1.5-fold compared to 5-FU (HR=0.657, 95%CI=0.495-0.870, p=0.004) and 5-FU plus INFa (HR=0.685, 95%CI=0.515-0.912, p=0.009). CONCLUSION: Our analysis clearly demonstrates for the first time an additional benefit of FA for adjuvant treatment of elderly CC patients. We conclude that this regimen is very safe and effective for adjuvant treatment of elderly patients. Copyright
RCT Entities:
AIM: Adjuvant treatment is still controversially discussed for elderly colon cancer (CC) patients. Our aim was to investigate the benefit of adjuvant treatment for younger (<70 years) and elderly (≥70 years) patients. PATIENTS AND METHODS: The long-term outcome of patients (n=855) enrolled in a randomized controlled trial comparing adjuvant chemotherapy with 5-FU alone, 5-FU plus folinic acid (FA), and 5-FU plus interferon-alpha (IFNa) was compared in younger (<70 years) and elderly (≥70 years) patients using a quotient of each patient's survival time and his expected residual life expectancy (QSL) and a multivariate Cox proportional hazards model. RESULTS: Eight-year overall survival (OS) rates were 58.3% and 57.4% for younger (n=653) and elderly (n=202) patients, respectively. In elderly patients, 8-year OS rates were 51.4%, 61.8%, and 56.3, and median QSL scores were 0.338, 0.371, and 0.343 for 5-FU (n=59), 5-FU plus FA (n=76), and 5-FU plus IFNa (n=67), respectively. In elderly patients treatment with 5-FU plus FA decreased the risk for an event by 1.5-fold compared to 5-FU (HR=0.657, 95%CI=0.495-0.870, p=0.004) and 5-FU plus INFa (HR=0.685, 95%CI=0.515-0.912, p=0.009). CONCLUSION: Our analysis clearly demonstrates for the first time an additional benefit of FA for adjuvant treatment of elderly CC patients. We conclude that this regimen is very safe and effective for adjuvant treatment of elderly patients. Copyright
Authors: Haidara Kherbek; Rima Daoud; Tania Soueycatt; Youssef Soueycatt; Zain Ali; Julia Ehsan; Zuheir Alshehabi; Michael Georgeos Journal: Ann Med Surg (Lond) Date: 2022-07-12