Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity

Goldvaser, Hadar; Shroitman, Noa Katz; Ben‐Aharon, Irit; Purim, Ofer; Kundel, Yulia; Shepshelovich, Daniel; Shochat, Tzippy; Sulkes, Aarón; Brenner, Baruch

doi:10.3748/wjg.v23.i8.1387

Cited by 16 publications

(10 citation statements)

References 33 publications

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“…This was despite patients ≥80 having larger and lower tumours with greater positive margin resection rates, which are factors that typically sway towards consideration of neoadjuvant and adjuvant treatment. This finding is consistent with retrospective analyses performed by Kunitake et al and Goldvaser et al [ 20 , 27 ]. Although the reasons were not reported in our database, increased toxicity together with questionable efficacy given that older patients are frequently excluded from trials appear to be the primary concerns [ 3 , 19 , 40 ].…”

Section: Discussionsupporting

confidence: 93%

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Current Treatment Approaches and Outcomes in the Management of Rectal Cancer Above the Age of 80

et al. 2021

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Background: The number of cases of rectal cancer in our older cohort is expected to rise with our ageing population. In this study, we analysed patterns in treatment and the long-term outcomes of patients older than 80 years with rectal cancer across a health district. Methods: All cases of rectal cancer managed at the Illawarra Cancer Care Centre, Australia between 2006 and 2018 were analysed from a prospectively maintained database. Patients were stratified into three age groups: ≤65 years, 66–79 years and ≥80 years of age. The clinicopathological characteristics, operative and non-operative treatment approach and survival outcomes of the three groups were compared. Results: Six hundred and ninety-nine patients with rectal cancer were managed, of which 118 (17%) were aged 80 and above. Patients above 80 were less likely to undergo surgery (71% vs. 90%, p < 0.001) or receive adjuvant/neoadjuvant chemoradiotherapy (p < 0.05). Of those that underwent surgical resection, their tumours were on average larger (36.5 vs. 31.5 mm, p = 0.019) and 18 mm closer the anal verge (p = 0.001). On Kaplan–Meier analysis, those above 80 had poorer cancer-specific survival when compared to their younger counterparts (p = 0.032), but this difference was no longer apparent after the first year (p = 0.381). Conclusion: Patients above the age of 80 with rectal cancer exhibit poorer cancer-specific survival, which is accounted for in the first year after diagnosis. Priority should be made to optimise care during this period. There is a need for further research to establish the role of chemoradiotherapy in this population, which appears to be underutilised.

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Section: Discussionsupporting

confidence: 93%

“…An age cut-off of 80 was selected being well above the median age at diagnosis of 70 [ 9 , 19 ]. Additionally, there has been growing interest in the management of octogenarians and nonagenarians across various oncological disciplines and we looked to gain further insight into this division of oncology [ 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Current Treatment Approaches and Outcomes in the Management of Rectal Cancer Above the Age of 80

et al. 2021

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“…However, other studies have indicated similar survival rates for both older and younger patients with CRC who have undergone curative surgery [ 3 ]. Moreover, octogenarian and nonagenarian patients have been excluded in a number of clinical trials [ 8 , 9 ]. Hutchins et al [ 10 ] reported that only 14% of elderly CRC patients (aged > 70 years) enrolled in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Colorectal Cancer in Octogenarian and Nonagenarian Patients: Clinicopathological Features and Survivals

Lee

Shin

2020

Ann Coloproctol

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Purpose: Elderly population will comprise a substantial proportion of colorectal cancer (CRC) patients. We examined patients older than 80 years according to their clinical and pathological characteristics to fully understand the elderly patients.Methods: CRC patients, 60 years or older at diagnosis, admitted between 2009 and 2014 at our hospital were enrolled. The patients were divided into 2 groups: elderly (aged > 80 years, n = 133), and controls (aged 60 to 79 years, n = 596). Patient’s demographics, risk factors for prognosis of CRC, Clinicopathological parameters, treatment, and survival rates were compared.Results: The mean ages were 83.9 and 64.8 years, respectively. Male-to-female ratio and tumor sidedness were comparable in both groups. Prognostic factors found in univariate analysis; differentiation, stage, lymphovascular invasion, and carcinoembryonic antigen showed no statistical difference. The microsatellite instability status and number of retrieved lymph nodes were also similar (17.2 vs 21.6, P = 0.505). A significant difference was found in the treatment approach for chemotherapy as the elderly patients with stage III and IV tend to have omitted adjuvant (43.6% vs. 92.8%, P < 0.001) or palliative (35.8% vs. 89.4%, P = 0.016) chemotherapy. Except in stage I, elderly patients showed significantly lower overall survival rates.Conclusion: Current study shows far-elderly patients with CRC were less likely to receive standard treatments, which might have resulted in an inferior outcome. As the number of elderly patients with CRC increase, our results provide a basis for further clinical and molecular investigations of elderly CRC patients.

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“…Dos lesiones menores a 1 cm, constituyeron adenocarcinomas. Los pólipos entre 1 y 2 cm correspondieron a tan solo el 8,42% del total de las lesiones, presentando en su mayoría histología tubulovellosa (12), seguidos de 8 tubulares, 3 hiperplásicos, 1 serrato. Veinticinco (8%) de los pólipos fueron mayores a 2 cm, predominando la histología tubulovellosa.…”

Section: Variables a Registrarunclassified

“…En la patogenia del CCR intervienen factores genéticos y medioambientales, como por ejemplo el tabaquismo, sedentarismo y obesidad entre otros. Para muchos individuos, la edad es el principal factor de riesgo, presentando un aumento en la incidencia a partir de la sexta década de la vida 3,12 . En base a estos datos, la mayoría de las guías recomiendan la realización de una colonoscopia de screening en todo aquel individuo asintomático mayor a 50 años 13 .…”

Section: Introductionunclassified

Utilidad de los factores pronósticos para la detección de lesiones pre-neoplásicas de colon

Bedini¹,

Trakál²,

Trakál³

2019

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INTRODUCCIÓN: El cáncer colorrectal (CCR) representa un problema de salud pública mundial. El objetivo de la participación de los pacientes en programas de screening de cáncer colorrectal (SCCR) es realizar undiagnóstico temprano y reducir la mortalidad. Los estudios endoscópicos son una herramienta clave para estratificar el riesgo y establecer el seguimiento de los pacientes. OBJETIVOS: Determinar la prevalencia de adenomas diagnosticados durante todos los estudios endoscópicos realizados en un periodo de 5 años. Establecer los factores de riesgo asociados a adenomas colorrectales. Estratificar en diferentes tipos de riesgo según la historia clínica del paciente y correlacionarlo con los hallazgos anatomopatológicos de los pólipos y el grado de displasia. PACIENTES Y MÉTODOS: Estudio observacional, retrospectivo, analítico. La población estudiada estuvo conformada por pacientes mayores de 18 años que se realizaron una videocolonoscopía (VCC) en el servicio de Gastroenterología de la Clínica Universitaria Reina Fabiola, en el período comprendido entre 1 diciembre de 2011 y 30 abril de 2017. Las fuentes de datos fueron informes de historia clínica, resultados de estudios endoscópicos y de anatomía patológica.Se analizaron variables demográficas, factores de riesgo para CCR, resultado anatomo-patológico de los pólipos y grado de displasia. Análisis estadístico: Para determinar la relación de diferentes factores de riesgos con el tipo de pólipo obtenido, se realizó un análisis univariado; test de Chi Cuadrado para variables categóricas y test T de Student para variables continuas. Todas las variables significativas en el análisis univariado se incluyeron en un análisis multivariado de regresión logística múltiple. RESULTADOS: La prevalencia de adenomas fue del 26%. Se halló una asociación entre el sexo masculino (p= 0,44), edad mayor a 50 años (p=0,001) y la detección de pólipos durante las colonoscopias de SCCR. Pertenecer a un grupo de riesgo determinado no influyó en el diagnóstico de adenomas (p=0,156). CONCLUSIONES: La prevalencia de pólipos de colon fue similar a la reportada por otros estudios.En el programa de SCCR, se observó una mayor frecuencia de pólipos en pacientes de sexo masculino y mayores de 50 años. Los grupos de riesgo no influyeron en el diagnóstico de adenoma.

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Octogenarian patients with colorectal cancer: Characterizing an emerging clinical entity

Cited by 16 publications

References 33 publications

Current Treatment Approaches and Outcomes in the Management of Rectal Cancer Above the Age of 80

Current Treatment Approaches and Outcomes in the Management of Rectal Cancer Above the Age of 80

Colorectal Cancer in Octogenarian and Nonagenarian Patients: Clinicopathological Features and Survivals

Utilidad de los factores pronósticos para la detección de lesiones pre-neoplásicas de colon

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