Adjuvant chemotherapy in elderly patients (≥75 yr) completely resected for colon cancer stage III compared to younger patients -: Toxicity and prognosis

Purpose. To compare benefits and risks to adjuvant chemotherapy following complete resection of node-positive colon cancer stage III for patients aged >= 75 yr and younger. Method. A retrospective study compared recurrence-free and overall survival, toxicity, and dose intensity of adjuvant bolus 5-FU according to the Mayo regimen chemotherapy in consecutive patients aged 19-74 (n = 203) and >= 75 yr (n = 24). Results. The estimated 5-yr proportional survival rates were 0.65 for patients age less than 75 yr compared to 0.65 (p = 0.96) for elderly. The frequencies of anemia (0%), thrombocytopenia (0%), leukopenia (4%), infection (8%), vomiting (0%), mucositis (17%), diarrhea (13%) CTC grade 3 or 4 toxicity in elderly patients were not sianificantly different from that in younger patients (p > 0.05). Significantly more elderly (8%) had a decline in performance status to grade 3 or 4, as compared to younger patients (4%) (p = 0.002). 5-FU dose reduction was necessary for significantly more elderly (51%) as compared to younger patients (28%) (p = 0.02), and fewer elderly (54%) completed the scheduled six treatment courses as compared to younger patients (82%) (p = 0.05). Conclusions. Adjuvant 5-FU chemotherapy should be considered for elderly patients aged :75 yr in good performance at high risk of recurrence of colon carcinoma after resection.