Survival outcomes of patients with stage III colorectal cancer aged ≥ 80 years who underwent curative resection: the HiSCO-04 prospective cohort study

• Published in: International journal of clinical oncology Vol. 29; no. 2; pp. 159 - 168
• Main Authors: Mochizuki, Tetsuya, Shimomura, Manabu, Nakahara, Masahiro, Adachi, Tomohiro, Ikeda, Satoshi, Saito, Yasufumi, Shimizu, Yosuke, Kochi, Masatoshi, Ishizaki, Yasuyo, Yoshimitsu, Masanori, Takakura, Yuji, Shimizu, Wataru, Sumitani, Daisuke, Kodama, Shinya, Fujimori, Masahiko, Oheda, Mamoru, Kobayashi, Hironori, Akabane, Shintaro, Yano, Takuya, Ohdan, Hideki
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.02.2024; Springer Nature B.V
• Subjects: Cancer; Cancer Research; Chemotherapy; Cohort analysis; Colorectal cancer; Colorectal carcinoma; Medical prognosis; Medicine; Medicine & Public Health; Oncology; Original Article; Surgical Oncology; Survival; Tegafur; Uracil; Elderly; Adjuvant chemotherapy; Colorectal cancer
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-023-02440-9

Background The efficacy of adjuvant chemotherapy in elderly patients aged ≥ 80 years with stage III colorectal cancer remains unclear. In parallel with a multicenter prospective phase II trial evaluating the efficacy of uracil-tegafur and leucovorin as adjuvant chemotherapy (HiSCO-03), we conducted a prospective observational study of these patients to assess survival outcomes, including those ineligible for chemotherapy. Methods This multi-institutional prospective cohort study included 17 institutions in Hiroshima, Japan. Patients aged ≥ 80 years with stage III colorectal cancer who underwent curative resection were enrolled. The primary endpoint was 3-year disease-free survival, and the secondary endpoints were 3-year overall and relapse-free survival. Propensity score matching was used to assess the effects of adjuvant chemotherapy on survival outcomes. Results A total of 214 patients were analyzed between 2013 and 2018, including 99 males and 115 females with a median age of 84 years (range 80–101 years). Recurrence occurred in 58 patients and secondary cancers were observed in 17. The 3-year disease-free, overall, and relapse-free survival rates were 63.3%, 76.9%, and 62.9%, respectively. Adjuvant chemotherapy was administered to 65 patients with a completion rate of 52%. In a study of 80 patients that adjusted for background factors using propensity score matching, patients who completed the planned treatment showed improved disease-free survival (3-year disease-free survival: completed, 80.0%; not received, 65.5%; and discontinued, 56.3%; p = 0.029). Conclusions Completion of adjuvant chemotherapy may improve the prognosis of patients with colorectal cancer aged ≥ 80 years, although the number of patients who would benefit from it is limited.