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- Title
Effect of oxaliplatin in elderly colon cancer patients with pathological T4 and/or N2 disease: a multicenter, propensity score-matched analysis.
- Authors
Tominaga, Tetsuro; Nonaka, Takashi; Oyama, Shosaburo; Shiraishi, Toshio; Takeshita, Hiroaki; Hisanaga, Makoto; Fukuoka, Hidetoshi; Fukuda, Akiko; Sumida, Yorihisa; Hashimoto, Shintaro; To, Kazuo; Tanaka, Kenji; Sawai, Terumitsu; Nagayasu, Takeshi
- Abstract
Purpose: Although adjuvant chemotherapy (AC) using fluoro-pyrimidine and oxaliplatin (FU + oxaliplatin) is recommended after curative resection for locally advanced colon cancer patients, several randomized controlled trials have shown no additional effect of oxaliplatin in patients aged ≥ 70 years. Here, we examined the effectiveness of FU + oxaliplatin on the long-term outcome of old patients with a high risk of recurrence. Methods: This multicenter, retrospective study included 346 colon cancer patients diagnosed with pathological T4 and/or N2 disease from 2016 to 2020. They were divided into an old group (≥ 70 years, n = 197) and a young group (< 70 years, n = 167). Propensity score matching was used to minimize selection bias, and 126 patients per group were matched. Results: Before matching, the rates of poor performance status (p < 0.001) and the presence of comorbidities (76.1% vs. 47.9%, p < 0.001) were higher in the old group. Although all baseline factors were similar between groups, after matching, the AC rate was lower in the old group (45.2% vs. 65.1%, p = 0.002). In the old group, relapse-free (82.2% vs. 55.6% and 69.6%, p < 0.05) and overall survival (83.1% vs. 80.0% and 44.4%, p < 0.05) rates were significantly higher in the AC patients with FU + oxaliplatin than in the AC patients with only FU and the non-AC patients. Conclusion: The selected old colon cancer patients with a high risk of recurrence gained an additional benefit with respect to prognosis from FU + oxaliplatin as AC.
- Subjects
COLON cancer; OXALIPLATIN; CANCER patients; PROPENSITY score matching; OLDER patients
- Publication
International Journal of Colorectal Disease, 2022, Vol 37, Issue 5, p1181
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-022-04159-x