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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

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Outcomes of Elderly Patients With Node-Positive Colon Cancer: A Multicenter Population-Based Cohort Study.

Carl Pinter¹, Shubham Sharma², Aunum Abid¹

¹College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

Clinical Colorectal Cancer

|December 20, 2024

Summary

Adjuvant chemotherapy significantly improves survival for elderly patients with stage III colon cancer. Factors like past cancer history and ostomy presence predict poorer outcomes, necessitating personalized treatment strategies.

Keywords:

Adjuvant chemotherapy Elderly patients Node-positive colon cancer Ostomy Surgery

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Area of Science:

Oncology
Geriatric Medicine
Epidemiology

Background:

Investigated prognostic factors for survival in elderly patients (≥70 years) with stage III colon cancer.
Utilized a large population-based cohort from Saskatchewan (2012-2018).

Purpose of the Study:

To determine the prognostic significance of clinical, pathological, and contextual variables on survival.
To evaluate the impact of adjuvant chemotherapy on overall survival (OS) and disease-free survival (DFS).

Main Methods:

Retrospective analysis of 404 elderly patients diagnosed with stage III colon cancer.
Cox proportional multivariate survival analysis to identify independent predictors of OS and DFS.

Main Results:

48% of patients were ≥80 years; 66% had comorbidities; 46% had high-risk disease.
Adjuvant chemotherapy improved 5-year DFS (49% vs. 30%) and OS (64% vs. 49%) (P < .001).
Independent predictors of poorer OS included past cancer history, ostomy, high node-positive to node-harvested ratio (>0.1), high-grade tumors, poor performance status, no chemotherapy, high-risk disease, and elevated CEA.

Conclusions:

Adjuvant chemotherapy offers a significant survival benefit for elderly patients with stage III colon cancer.
Past cancer history, ostomy presence, and higher node-positive to node-harvested ratios are key predictors of worse outcomes.
Personalized treatment approaches are crucial for improving survival in this patient population.