Treatment of metastatic colorectal cancer patients 75 years old in clinical practice: A multicenter analysis

Roberta Grande, Clara Natoli, Fabrizio Ciancola, Donatello Gemma, Arianna Pellegrino, Ida Pavese, Carlo Garufi, Luigi Di Lauro, Domenico Corsi, Diego Signorelli, Isabella Sperduti, Giada Cortese, Emanuela Risi, Federica Morano, Domenico Sergi, Carlo Signorelli, Enzo Maria Ruggeri, Germano Zampa, Marco Russano, Teresa Gamucci

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Colorectal cancer patients have a median age of incidence >65years although they are largely under-represented in phase-III trials. This large population contains patients unfit for treatment, those suitable for monotherapy or for doublets and the impact of chemotherapy outside clinical trial is unclear. The aim of the study was to retrospectively analyse Overall Survival(OS) of elderly metastatic colorectal cancer(mCRC) patients treated with chemotherapy in daily practice. Methods Kaplan-Meir method was used for OS, the log-rank or Tarone-Ware test for differences between subgroups, Cox's proportional hazard model to assess the impact of known prognostic factors and treatment. Results 751 patients with mCRC observed between January 2000 and January 2013 were collected. Median age was 79 year(75-93); Male/Female 61/39%, ECOG-PS 0-1/2 85/15%; colon/rectum 74/26%; multiple metastatic sites 34%, only liver metastasis in 41% of patients. KRAS status was studied in 35% of patients: 44% of them showed gene mutation. 20.5% of patients did not received any kind of treatment including surgery. Comorbidities observed: cardiovascular 34%, diabetes 14%, hypertension 50%. Primary tumor was resected in 80.6%; surgery of liver metastasis was done in 19% of patients (2.3% of patients >80years). 78% of patients underwent chemotherapy. Median follow up was 12 months (range 1-124). Median OS was 17 months (CI 95%15-19);median OS in no-treated patients was 5 months (4-6); mOS of patients with at least one treatment was 20 months (18-22). In KRAS mutated group median OS was 19months (15-23) while in KRAS wild type patients median OS was 25 months (20-30). At multivariate analysis sex(Female), age (80 years old or with a poor performance status (respectively p

Original languageEnglish
Article numbere0157751
JournalPLoS One
Volume11
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

Fingerprint

Chemotherapy
colorectal neoplasms
Colorectal Neoplasms
Liver
Surgery
Medical problems
Tumors
Hazards
Therapeutics
Genes
Survival
drug therapy
Drug Therapy
metastasis
surgery
Neoplasm Metastasis
liver
rectum
Survival Analysis
Proportional Hazards Models

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Grande, R., Natoli, C., Ciancola, F., Gemma, D., Pellegrino, A., Pavese, I., ... Gamucci, T. (2016). Treatment of metastatic colorectal cancer patients 75 years old in clinical practice: A multicenter analysis. PLoS One, 11(7), [e0157751]. https://doi.org/10.1371/journal.pone.0157751

Treatment of metastatic colorectal cancer patients 75 years old in clinical practice : A multicenter analysis. / Grande, Roberta; Natoli, Clara; Ciancola, Fabrizio; Gemma, Donatello; Pellegrino, Arianna; Pavese, Ida; Garufi, Carlo; Di Lauro, Luigi; Corsi, Domenico; Signorelli, Diego; Sperduti, Isabella; Cortese, Giada; Risi, Emanuela; Morano, Federica; Sergi, Domenico; Signorelli, Carlo; Ruggeri, Enzo Maria; Zampa, Germano; Russano, Marco; Gamucci, Teresa.

In: PLoS One, Vol. 11, No. 7, e0157751, 01.07.2016.

Research output: Contribution to journalArticle

Grande, R, Natoli, C, Ciancola, F, Gemma, D, Pellegrino, A, Pavese, I, Garufi, C, Di Lauro, L, Corsi, D, Signorelli, D, Sperduti, I, Cortese, G, Risi, E, Morano, F, Sergi, D, Signorelli, C, Ruggeri, EM, Zampa, G, Russano, M & Gamucci, T 2016, 'Treatment of metastatic colorectal cancer patients 75 years old in clinical practice: A multicenter analysis', PLoS One, vol. 11, no. 7, e0157751. https://doi.org/10.1371/journal.pone.0157751
Grande, Roberta ; Natoli, Clara ; Ciancola, Fabrizio ; Gemma, Donatello ; Pellegrino, Arianna ; Pavese, Ida ; Garufi, Carlo ; Di Lauro, Luigi ; Corsi, Domenico ; Signorelli, Diego ; Sperduti, Isabella ; Cortese, Giada ; Risi, Emanuela ; Morano, Federica ; Sergi, Domenico ; Signorelli, Carlo ; Ruggeri, Enzo Maria ; Zampa, Germano ; Russano, Marco ; Gamucci, Teresa. / Treatment of metastatic colorectal cancer patients 75 years old in clinical practice : A multicenter analysis. In: PLoS One. 2016 ; Vol. 11, No. 7.
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abstract = "Background Colorectal cancer patients have a median age of incidence >65years although they are largely under-represented in phase-III trials. This large population contains patients unfit for treatment, those suitable for monotherapy or for doublets and the impact of chemotherapy outside clinical trial is unclear. The aim of the study was to retrospectively analyse Overall Survival(OS) of elderly metastatic colorectal cancer(mCRC) patients treated with chemotherapy in daily practice. Methods Kaplan-Meir method was used for OS, the log-rank or Tarone-Ware test for differences between subgroups, Cox's proportional hazard model to assess the impact of known prognostic factors and treatment. Results 751 patients with mCRC observed between January 2000 and January 2013 were collected. Median age was 79 year(75-93); Male/Female 61/39{\%}, ECOG-PS 0-1/2 85/15{\%}; colon/rectum 74/26{\%}; multiple metastatic sites 34{\%}, only liver metastasis in 41{\%} of patients. KRAS status was studied in 35{\%} of patients: 44{\%} of them showed gene mutation. 20.5{\%} of patients did not received any kind of treatment including surgery. Comorbidities observed: cardiovascular 34{\%}, diabetes 14{\%}, hypertension 50{\%}. Primary tumor was resected in 80.6{\%}; surgery of liver metastasis was done in 19{\%} of patients (2.3{\%} of patients >80years). 78{\%} of patients underwent chemotherapy. Median follow up was 12 months (range 1-124). Median OS was 17 months (CI 95{\%}15-19);median OS in no-treated patients was 5 months (4-6); mOS of patients with at least one treatment was 20 months (18-22). In KRAS mutated group median OS was 19months (15-23) while in KRAS wild type patients median OS was 25 months (20-30). At multivariate analysis sex(Female), age (80 years old or with a poor performance status (respectively p",
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AU - Grande, Roberta

AU - Natoli, Clara

AU - Ciancola, Fabrizio

AU - Gemma, Donatello

AU - Pellegrino, Arianna

AU - Pavese, Ida

AU - Garufi, Carlo

AU - Di Lauro, Luigi

AU - Corsi, Domenico

AU - Signorelli, Diego

AU - Sperduti, Isabella

AU - Cortese, Giada

AU - Risi, Emanuela

AU - Morano, Federica

AU - Sergi, Domenico

AU - Signorelli, Carlo

AU - Ruggeri, Enzo Maria

AU - Zampa, Germano

AU - Russano, Marco

AU - Gamucci, Teresa

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N2 - Background Colorectal cancer patients have a median age of incidence >65years although they are largely under-represented in phase-III trials. This large population contains patients unfit for treatment, those suitable for monotherapy or for doublets and the impact of chemotherapy outside clinical trial is unclear. The aim of the study was to retrospectively analyse Overall Survival(OS) of elderly metastatic colorectal cancer(mCRC) patients treated with chemotherapy in daily practice. Methods Kaplan-Meir method was used for OS, the log-rank or Tarone-Ware test for differences between subgroups, Cox's proportional hazard model to assess the impact of known prognostic factors and treatment. Results 751 patients with mCRC observed between January 2000 and January 2013 were collected. Median age was 79 year(75-93); Male/Female 61/39%, ECOG-PS 0-1/2 85/15%; colon/rectum 74/26%; multiple metastatic sites 34%, only liver metastasis in 41% of patients. KRAS status was studied in 35% of patients: 44% of them showed gene mutation. 20.5% of patients did not received any kind of treatment including surgery. Comorbidities observed: cardiovascular 34%, diabetes 14%, hypertension 50%. Primary tumor was resected in 80.6%; surgery of liver metastasis was done in 19% of patients (2.3% of patients >80years). 78% of patients underwent chemotherapy. Median follow up was 12 months (range 1-124). Median OS was 17 months (CI 95%15-19);median OS in no-treated patients was 5 months (4-6); mOS of patients with at least one treatment was 20 months (18-22). In KRAS mutated group median OS was 19months (15-23) while in KRAS wild type patients median OS was 25 months (20-30). At multivariate analysis sex(Female), age (80 years old or with a poor performance status (respectively p

AB - Background Colorectal cancer patients have a median age of incidence >65years although they are largely under-represented in phase-III trials. This large population contains patients unfit for treatment, those suitable for monotherapy or for doublets and the impact of chemotherapy outside clinical trial is unclear. The aim of the study was to retrospectively analyse Overall Survival(OS) of elderly metastatic colorectal cancer(mCRC) patients treated with chemotherapy in daily practice. Methods Kaplan-Meir method was used for OS, the log-rank or Tarone-Ware test for differences between subgroups, Cox's proportional hazard model to assess the impact of known prognostic factors and treatment. Results 751 patients with mCRC observed between January 2000 and January 2013 were collected. Median age was 79 year(75-93); Male/Female 61/39%, ECOG-PS 0-1/2 85/15%; colon/rectum 74/26%; multiple metastatic sites 34%, only liver metastasis in 41% of patients. KRAS status was studied in 35% of patients: 44% of them showed gene mutation. 20.5% of patients did not received any kind of treatment including surgery. Comorbidities observed: cardiovascular 34%, diabetes 14%, hypertension 50%. Primary tumor was resected in 80.6%; surgery of liver metastasis was done in 19% of patients (2.3% of patients >80years). 78% of patients underwent chemotherapy. Median follow up was 12 months (range 1-124). Median OS was 17 months (CI 95%15-19);median OS in no-treated patients was 5 months (4-6); mOS of patients with at least one treatment was 20 months (18-22). In KRAS mutated group median OS was 19months (15-23) while in KRAS wild type patients median OS was 25 months (20-30). At multivariate analysis sex(Female), age (80 years old or with a poor performance status (respectively p

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