Influence of age and comorbidity on prognosis and application of adjuvant chemotherapy in elderly Ja

Worldwide, colorectal cancer (CRC) remains the fourth major cause of cancer-related deaths. CRC and comorbidities are largely diagnosed at old age; hence, it is possible that age and comorbidities affect treatment pattern of and prognosis in CRC patients. Given the differential prevalence of comorbidities among countries, the study sought to investigate the effect of age and comorbidity on the application of adjuvant therapy and prognosis in elderly Japanese CRC patients.

The retrospective cohort study used data on 4,593 CRC (stage I-III) patients who underwent surgical resection between 2004 and 2006. Overall comorbidity in the sample was evaluated with the Charlson comorbidity index (CCI). The associations of age and CCI with receipt of adjuvant therapy and CRC prognostic outcomes – overall (OS), CRC-specific and disease-free survival (DFS) – were investigated with the Cox model, adjusting for potential confounding factors.

The authors found that aging and increasing CCI score (only in patients <75 years) were associated with not receiving adjuvant therapy and worse OS and DFS. The prognostic impacts of age and comorbidity appeared to decrease with increasing CRC stage. However, it is unclear where (medical or administrative records) and when (before or around the time of CRC diagnosis) the comorbidities used in the study were ascertained

Original article: Yamano T et al (2017) Influence of age and comorbidity on prognosis and application of adjuvant chemotherapy in elderly Japanese patients with colorectal cancer: A retrospective multicentre study Eur J Cancer. 2017 Aug;81:90-101. doi: 10.1016/j.ejca.2017.05.024.