Adjuvant Chemotherapy in Elderly Patients with Colon Cancer: A Retrospective Study
Notice bibliographique
Résumé
Purpose: Although benefits have been clearly demonstrated for stage III colon cancer, the effects of adjuvant chemotherapy on the elderly population have been questioned. This study was undertaken to review our local experience with diagnosis, staging, and treatment of colon cancer in this population. Methods: All patients aged ≥75 years operated for colon cancer at the Centre Hospitalier Universitaire de Sherbrooke between 2005 and 2012 were identified. Information related to diagnostic modalities, type of surgeries, perioperative complications, pathology results, chemotherapy treatment, and overall outcomes were retrospectively analyzed. Overall survival (OS) and disease-free survival (DFS) were estimated with Kaplan-Mayer plots. Results: A total of 205 patients were included (mean age 81.3±4.5 years; 43.9% of males). The major comorbidities were hypertension (71.2%), coronary artery disease (32.2%), peripheral artery disease (21.5%), diabetes (21.0%), prior neoplasia (16.1%), chronic bronchitis (14.1%), and chronic renal failure (13.7%). For staging purpose, colonoscopy was performed in 88.8% of patients, preoperative CEA in 85.4%, abdominal CT in 87.3%, chest CT in 46.3%, and PET CT in 11.2%. There were 54.1% of perioperative complications, the most frequent being infections (40.5%), cardiovascular events (21.6%), ileus/obstruction (9.9%), bleeding (7.2%), delirium (5.4%), and thromboembolic events (5.4%).The perioperative 30-day mortality was 5.4%, and infections were responsible for 88.8% of these deaths. According to the AJCC classification V.7, tumors were identified as stage 0, I, II, and III in 1%,17.6%, 42.4%, and 39% of cases, respectively. In stage II patients, 26.1% were evaluated in oncology, and 4.5% had chemotherapy that consisted of capecitabine in 50% and 5-FU/LV in 50%. Whereas for stage III patients, 58.8% were evaluated in oncology, and 28.8% of them received adjuvant treatment. For stage III patients, chemotherapy regimens were capecitabine in 82.6%, FOLFOX in 8.7%, infusional 5-FU/LV in 4.3%, and bolus 5-FU in 4.3%. It was the surgeon's, the patient's, or the oncologist's decision to decline treatment in 33.3%, 29.8%, and 26.3%, respectively, for stage III patients. Overall, neither DFS at 5 years was significantly improved (59.2% vs. 56.9%; p=0.98) nor was OS at 5 years (58.3% vs. 60.3%; p=0.98) in patients treated with vs. without adjuvant chemotherapy. Results were similar in the stage III population, with 5-year DFS of 60.2% vs. 38% (p=0.22) and 5-year OS of 59.8% vs. 41.9% (p=0.24). Conclusion: Our local experience did not show any improvement on disease-free survival and on overall survival for elderly patients treated with adjuvant chemotherapy for colon cancer.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».