Chemotherapy for colorectal cancer in the elderly

Table 1 Major studies regarding adjuvant chemotherapy in elderly patients with colon cancer

Ref.	Type of study	No. of total patients	No. of older patients/age (yr)	Endpoint	Outcome [HR (95%CI)]
Iwashyna et al[23]	Population-based cohort study (SEER-Medicare)	3357	3357 (100%)/≥ 70	5-FU vs observation:	OS: 0.73 (0.65-0.82)
				OS
Sargent et al[24]	Pooled analysis of 7 randomized phase III trials	3351	506 (15%)/≥ 70	5-FU/LV vs observation:	(1) TTR: 0.68 (0.60-0.76; P < 0.01)
				(1) TTR	(2) OS: 0.76 (0.68-0.85; P < 0.01)
				(2) OS
Sanoff et al[26]	Retrospective, database analysis (SEER-Medicare, NSYSCR, CanCONS, NCCN)	5489	5489 (100%)/≥ 75	OS in stage III:	(1) 0.60 (0.53-0.68)
				(1) CTx vs no CTx	(2) SEER-Medicare: 0.84 (0.69-1.04)
				(2) Oxaliplatin-based vs non-oxaliplatin regimens	NYSCR: 0.82 (0.51-1.33)
McCleary et al[27]	ACCENT group analysis in stage II/III	14528	2575 (22%)/≥ 70	5-FU/LV or oral 5-FU vs combination regimens: DFS, OS, TTR in (1) older and (2) younger patients	(1) DFS: 1.05 (0.94-1.19; P = 0.09)
					OS: 1.08 (0.95-1.23; P = 0.05)
					TTR: 1.06 (0.93-1.22; P = 0.36)
					(2) DFS: 0.89 (0.80-0.99; P < 0.01)
					TTR: 0.88 (0.79-0.98; P = 0.02)
					OS: 1.08 (0.95-1.23; P = 0.04)1
Yothers et al[28]	Exploratory subset analysis of updated results of NSABP C-07 trial	2409	396 (16%)/≥ 70	5-FU/LV vs oxaliplatin plus 5-FU/LV:
				(1) DFS	(1) DFS: 1.03 (0.77-1.36; P = 0.87)
				(2) OS	(2) OS: 1.18 (0.86-1.62; P = 0.30)
Tournigand et al[29]	Subgroup analysis of MOSAIC trial for stage II disease and elderly patients	2246	315 (14%)/70-75	5-FU/LV vs FOLFOX4:
				(1) DFS	(1) DFS: 0.93 (0.64-1.35; P = 0.73)
				(2) OS	(2) OS: 1.10 (0.73-1.65; P = 0.66)

¹The benefit of adding oxaliplatin was restricted to patients younger than 70 years for OS. CTx: Chemotherapy; DFS: Disease-free survival; 5-FU/LV: 5-Fluorouracil/leucovorin; OS: Overall survival; TTR: Time to recurrence.