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Management of Advanced Colon Cancer in a Community Hospital—Impact of Age on Clinical Management and Survival

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Abstract

Purpose

Colon cancer is more common in the elderly than in younger and middle-aged people. Cancer clinical trials focus more on younger patients and the management of elderly patients with advanced disease is still unclear.

Methods

We studied all patients presenting with colon adenocarcinoma metastasis to liver at a community teaching hospital from Dec 2000 through Dec 2007 by a retrospective review of Tumor Registry data and patient chart review with focus on age, clinical management, decision making, and survival. Sixty-seven patients with a median age of 69 and a male to female ratio of 31:36 were identified.

Results

The patients with obstructive symptoms and Eastern Cooperative Oncology Group performance status on presentation though varied little by age, smaller proportion of elderly patients underwent resection of the primary bowel tumor in the presence of liver metastases with ten of 16 (63%) aged 80 or greater being managed without surgery. The percentage of patient’s preference to physician’s preference for patients not undergoing the primary bowel resection increased for older age group. Median survival decreased significantly with age (p < 0.05).

Conclusions

Age-related clinical management, decision-making autonomy, and survival are apparent in this study, and there was an increasing trend of patient’s involvement in decision making as the age increases and, thus, affecting the age-related clinical management.

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Authors and Affiliations

  1. Department of Internal Medicine, Unity Health System, 1555 Long Pond Rd, Rochester, NY, 14626, USA

    Sujatha Mogili & Mobeen Yousaf

  2. Department of Surgery, Unity Health System, Rochester, NY, USA

    Nagendra Nadaraja

  3. Department of Hematology and Oncology, Unity Health System, Rochester, NY, USA

    Timothy Woodlock

Authors
  1. Sujatha Mogili
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  2. Mobeen Yousaf
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  3. Nagendra Nadaraja
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  4. Timothy Woodlock
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Correspondence to Sujatha Mogili.

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Mogili, S., Yousaf, M., Nadaraja, N. et al. Management of Advanced Colon Cancer in a Community Hospital—Impact of Age on Clinical Management and Survival. J Gastrointest Canc 43, 426–430 (2012). https://doi.org/10.1007/s12029-011-9308-7

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  • DOI: https://doi.org/10.1007/s12029-011-9308-7

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