Treatment patterns and primary reasons for adjusted treatment in older and younger patients with stage II or III colorectal cancer.

Autor: Scheepers ERM; Department of Internal Medicine, Diakonessenhuis, Utrecht, the Netherlands. Electronic address: escheepers@diakhuis.nl., Schiphorst AH; Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands., van Huis-Tanja LH; Department of Internal Medicine, Diakonessenhuis, Utrecht, the Netherlands., Emmelot-Vonk MH; Department of Geriatric Medicine, University Medical Centre Utrecht, the Netherlands., Hamaker ME; Department of Geriatric Medicine, Diakonessenhuis, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2021 Jul; Vol. 47 (7), pp. 1675-1682. Date of Electronic Publication: 2021 Feb 03.
DOI: 10.1016/j.ejso.2021.01.029
Abstrakt: Objective: This study aims to assess age-related treatment patterns and primary reasons for adjusted treatment in patients with colorectal cancer.
Methods: Patients with colorectal cancer stage II or III diagnosed between 2015 and 2018 in the Netherlands were eligible for this study. Data were provided by the Netherlands Cancer Registry and included socio-demographics, clinical characteristics, treatment patterns and primary reasons for adjusted treatment. Treatment patterns and reasons for adjusted treatment were analysed according to age groups.
Results: Of all 29,620 patients, 30% were aged <65 years (n = 8994), 34% between 65 and 75 years (n = 10,173), 27% between 75 and 85 years (n = 8102) and 8% were ≥85 years (n = 2349). Irrespective of cancer location or stage, older patients received less frequently a combination of surgery and (neo)adjuvant therapy compared to younger patients (decreasing from 55% to 1% in colon cancer patients, and from 71% to 23% in rectal cancer patients aged <65 years and ≥85 years respectively). Omission of surgical treatment increased with age in both patients with colon cancer (ranging from 1% in patients aged <65 years to 16% in those ≥85 years) and rectal cancer (ranging from 12% in patients aged <65 years to 56% in those ≥85 years). The most common reasons for adjusted treatment were patient preference (27%) and functional status (20%), both reasons increased with advancing age.
Conclusions: Guideline non-adherence increased with advancing age and omission of standard treatment was mainly based on patient preference and functional status. These findings provides insight in the treatment decision-making process in patients with colorectal cancer. Future research is necessary to further assess patient's role in the treatment decision-making process.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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