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Prognostic factors for stage III colon cancer in patients 80 years of age and older

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Oncological strategies in the elderly population are debated. The objective of this study was to assess the factors predictive of poor prognosis in elderly patients with stage III colon cancer.

Methods

A retrospective review of demographic, pathologic, treatment, and outcome data from 308 patients with stage III colon adenocarcinoma who had undergone surgery between 2007 and 2014 was conducted. A proportional hazards model was used to assess the association of prognostic factors with disease-free survival (DFS) and overall survival (OS).

Results

The 5-year survival rate was 34.4% (95% CI 27.1–39.8%) and Charlson comorbidity index was a significant predictor of death (p < 0.01). The presence of perineural invasion (p = 0.03) and incomplete resection (p < 0.001) were significantly correlated with OS. The postoperative (30 days) mortality rate was 11.7%. Adjuvant chemotherapy was significantly associated with better OS (p < 0.001) independently of the regimens. Disease-free survival was significantly correlated with adjuvant chemotherapy (HR 0.63, 95% CI: 0.42–0.97, p = 0.034), Charlson comorbidity index (CCI 5; HR 1.61, 95% CI: 1.05–2.48, p = 0.029), and venous and/or perineural invasion (HR 1.54, 95% CI: 1.03–2.29, p = 0.035).

Conclusion

Age, comorbidities, tumor histology, and adjuvant chemotherapy were independent predictors of prognosis in patients with stage III colon cancer. These data can be used to identify elderly patients with poor prognosis and to design future tailored randomized clinical trials.

Trial registration

ClinicalTrial.gov No. NCT04526314. Date of registration 25 August 2020

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Data availability

All data are presented in the present manuscript or the supplementary material.

Code availability

Not applicable

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Authors

Contributions

All authors participated in the content and design of the study, the preparation of the manuscript and its revisions, and final approval. This publication is approved by all authors and by the responsible authorities where the work was carried out. All authors give their final approval of the version to be published, and their agreement to be accountable for all aspects of the work.

Contributor roles in accordance with the CRediT Taxonom: BB, MC, JPN, MR, LQ: Conceptualization; MO, MC, TK, SB: Data curation;

BB, MO, MC: Formal analysis; N/A: Funding acquisition; BB, MO, MC, TK, SB: Investigation; BB, MO, MC, JPN, MR, LQ: Methodology; BB, MC, JPN, MR: Project administration; JPN, MR: Resources; BB, MC: Software; JPN, MR, LQ: Supervision; BB, MO, MC, TK, SB, JPN, MR, LQ: Validation; BB, MC, MR, LQ: Visualization; BB, JPN, MR, LQ: Writing – original draft; BB: Writing – review and editing.

Corresponding author

Correspondence to Bogdan Badic.

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The authors declare no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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As a retrospective and non-interventional one, the present study based on the data from the digestive cancer registry did not require informed consent of the patients and it was conducted in accordance with our national and institutional guidelines (French law text “loi Jardé n°2012–300”) and after approval by our institutional review board.

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Badic, B., Oguer, M., Cariou, M. et al. Prognostic factors for stage III colon cancer in patients 80 years of age and older. Int J Colorectal Dis 36, 811–819 (2021). https://doi.org/10.1007/s00384-021-03861-6

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