The Role of Adjuvant Therapy in the Elderly
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- Wu, C. & Goldberg, R.M. Curr Colorectal Cancer Rep (2013) 9: 286. doi:10.1007/s11888-013-0175-4
Colorectal cancer is the third commonest cancer and second commonest cancer killer in the USA. With a median age at diagnosis of 72 years, it largely affects the elderly population. However, there is a lack of objective data with which to answer clinically relevant questions regarding adjuvant therapy in the geriatric patient population because mainly younger patients are enrolled in clinical trials. Elderly patients are undertreated in the adjuvant setting owing to multiple factors, including physician decision and patient preference. Older patients have different tumor biology, physiologic factors, and social situations to consider in comparison with younger patients. Thus, geriatric patients require more thorough assessment of their functional status and existing medical conditions as they are at risk of increased toxicities from chemotherapy and their ongoing treatment requires vigilance. Elderly patients do benefit from adjuvant chemotherapy, although subgroup analyses show that many do not derive incremental benefit from the addition of oxaliplatin to 5-fluorouracil therapy.