TITLE:
Prognostic Factors in Geriatric Patients with Metastatic Colon Cancer
AUTHORS:
Kenji Ina, Megumi Kabeya, Shu Yuasa, Yuko Kato, Satoshi Kayukawa, Takae Kataoka, Ryuichi Furuta
KEYWORDS:
Metastatic Colon Cancer, Chemotherapy, Comprehensive Geriatric Assessment, TMIG Index of Competence
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.10 No.10,
September
26,
2019
ABSTRACT: Backgrounds: Colorectal cancer is an important
contributor to cancer morbidity and mortality. Given that many older adult
patients often have concomitant diseases and impairments in organ function,
they are at increased risk for chemotherapy toxicity. Therefore, it is
important to identify prognostic factors in older patients undergoing
chemotherapy. Methods: We performed a retrospective chart review of
colorectal cancer patients treated at Nagoya Memorial Hospital between 2012 and
2017 and selected those who received chemotherapy for metastatic colon cancer.
Overall survival was calculated from the beginning of chemotherapy until death
or the most recent follow-up date. We used the Kaplan-Meier method to plot
survival curves and performed a statistical comparison using a log-rank test.
In addition, multivariate analysis was performed using stepwise Cox
proportional hazards models. Finally, a comprehensive geriatric assessment was
conducted for older patients. The chart review was approved by the ethics
committee of Nagoya Memorial Hospital. Results: The overall survival of
metastatic colon cancer patients was not markedly different between patients
aged ≥ 65 years of age (N = 37). Neither lesion
site nor the RAS status affected
survival, whereas the usage of three kinds of cytotoxic agents prolonged
longevity. In a multivariate analysis of patients ≥ 65 years of age, the only independent
prognostic factor for survival was the functional capacity, as measured by the
Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. Conclusions: A combination of the comprehensive geriatric assessment and TMIG index was
useful for predicting the longevity in patients with metastatic colon cancer ≥ 65 years of age.