scholarly journals Palliative chemotherapy in advanced colorectal cancer patients 80 years of age and older

2016 ◽  
Vol 23 (3) ◽  
pp. 144 ◽  
Author(s):  
P. Lai ◽  
S. Sud ◽  
T. Zhang ◽  
T. Asmis ◽  
P. Wheatley-Price
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
White Blood Cells ◽  
Significant Proportion ◽  
Retrospective Chart Review ◽  
Assessment Tools ◽  
Prescription Medications ◽  
Patient Demographics ◽  
Few Data ◽  
Colorectal Cancer Patients

Background Colorectal cancer (CRC) has a median diagnostic age of 68 years. Despite significant progress in chemotherapy (CTX) options, few data on outcomes or toxicity from ctx in patients 80 years of age and older are available. We investigated CTX in such patients with metastatic CRC (MCRC), hypothesizing high rates of hospitalization and toxicity. MethodsA retrospective chart review identified patients 80 years of age and older with MCRC who initiated CTX between 2005–2010 at our institution. Patient demographics and CTX data were collected. Endpoints included rates of hospitalization, CTX discontinuation because of toxicity, and overall survival. ResultsIn 60 patients, CTX was initiated on 88 occasions. Median age in the cohort was 83 years; 52% were men; 72% lived with family; 53% had a modified Charlson comorbidity index of 2 or greater; and 31% were taking 6 or more prescription medications at baseline. At baseline, 33% of the patients were anemic (hemoglobin < 100 g/L), 36% had leukocytosis (white blood cells > 11×109/L), and 48% had renal impairment (estimated glomerular filtration rate < 60 mL/min/1.73 m2). In 53%, CTX was given as first-line treatment. The initial CTX dose was adjusted in 67%, and capecitabine was the most common chemotherapeutic agent (45%). In 19 instances (22%), the patient was hospitalized during or within 30 days of CTX; in 26 instances (30%), the CTX was discontinued because of toxicity, and in 48 instances (55%), the patient required at least 1 dose reduction, omission, or delay. Median overall survival was 17.8 months (95% confidence interval: 14.3 to 20.8 months).ConclusionsIn the population 80 years of age and older, CTX for MCRC is feasible; however, most recipients will require dose adjustments, and a significant proportion will be hospitalized or stop CTX because of toxicity. Prospective research incorporating geriatric assessment tools is required to better select these older patients for CTX.

Palliative chemotherapy in advanced colorectal cancer patients age 80 or older.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14598-e14598
Author(s):  
Pamela Lai ◽  
Shelly Sud ◽  
Tinghua Zhang ◽  
Timothy R. Asmis ◽  
Paul Wheatley-Price
Keyword(s):  
Colorectal Cancer ◽  
Performance Status ◽  
Retrospective Chart Review ◽  
Standard Of Care ◽  
Assessment Tools ◽  
Prescription Medications ◽  
Ct Dose ◽  
Comorbidity Index ◽  
Ct Data ◽  
Colorectal Cancer Patients

e14598 Background: Colorectal cancer (CRC) is the second most common cancer worldwide, with a median age at diagnosis of 71 years. While there has been significant progress in chemotherapy (CT) options for metastatic CRC (mCRC) patients (pts) over the past decade, there is very little data on outcomes or toxicity from CT in mCRC pts aged ≥80 years. We investigated palliative CT in the 80+ mCRC population, hypothesizing that high rates of hospitalization and toxicity may be observed. Methods: With ethics approval, a retrospective chart review was conducted of pts ≥80 years with mCRC who initiated a CT course between June 2005 and November 2009 at our institution. Baseline data on pt demographics were collected, in addition to CT data. The endpoints included: rates of hospitalization, CT discontinuation due to toxicity, and overall survival (OS). Results: CT was initiated on 88 occasions during the study period. The median age was 83 (range 80-92) and 52% of pts were male. Where data were available, 60% of pts had a good performance status (PS) of ECOG 0-1, 20% PS 2 and 9% PS 3 (10% unknown). 63 pts (72%) lived with family and 23% lived alone. 76% had a Charlson Comorbidity Index (CCI) ≥7 and 31% were taking ≥6 baseline prescription medications. At baseline, 33% of pts were anemic (Hgb <100), 36% had leukocytosis (WBC>11) and 48% had renal impairment (eGFR <60). Palliation was the intent for 95% of cases and 47 pts (53%) were receiving first line CT. The initial CT dose was adjusted from standard of care in 67% of cases. The most common CT was capecitabine monotherapy (45%). In total 19 pts (22%) were hospitalized during or within 30 days of CT; 26 pts (30%) discontinued CT due to toxicity, and 48 pts (55%) required at least 1 dose reduction, delay or omission. The median OS was 14.6 months (95% CI 11.7-18.6). No baseline factors (age, sex, PS, CCI, line of CT, baseline dose adjustment, baseline blood work) were associated with hospitalization, CT discontinuation due to toxicity, or OS. Conclusions: Palliative CT for mCRC in the ≥80 population is feasible, but most pts will require dose adjustments, and a significant minority will be hospitalized or stop CT due to toxicity. Prospective research incorporating geriatric assessment tools is required.

scholarly journals IMPACT OF KRAS MUTATIONS IN CLINICAL FEATURES IN COLORECTAL CANCER

2020 ◽  
Vol 33 (3) ◽  
Author(s):  
Renato Morato ZANATTO ◽  
Gianni SANTOS ◽  
Júnea Caris OLIVEIRA ◽  
Eduardo Marcucci PRACUCHO ◽  
Adauto José Ferreira NUNES ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Kras Mutation ◽  
Direct Sequencing ◽  
Colorectal Carcinogenesis ◽  
Kras Mutations ◽  
Primary Tumor Site ◽  
Exon 2 ◽  
Metastatic Site ◽  
Colorectal Cancer Patients

ABSTRACT Background: KRAS mutations are important events in colorectal carcinogenesis, as well as negative predictors of response to EGFR inhibitors treatment. Aim: To investigate the association of clinical-pathological features with KRAS mutations in colorectal cancer patients treated. Methods: Data from 69 patients with colorectal cancer either metastatic at diagnosis or later, were retrospectively analyzed. The direct sequencing and pyrosequencing techniques were related to KRAS exon 2. The mutation diagnosis and its type were determined. Results: KRAS mutation was identified in 43.4% of patients. The most common was c.35G>T (p.G12V), c.35G>A (p.G12D) and c.38G>A (p.G13D). No correlation was found between KRAS mutation and age (p=0.646) or gender (p=0.815). However, mutated group had higher CEA levels at admission (p=0.048) and codon 13 mutation was associated with involvement of more than one metastatic site in disease progression (p=0.029). Although there was no association between primary tumor site and mutation diagnosis (p=0.568), primary colon was associated with worse overall survival (p=0.009). Conclusion: The KRAS mutation was identified in almost half of patients. Mutated KRAS group had higher levels of CEA at admission and the mutation at codon 13 was associated with involvement of more than one metastatic site in the course of the disease. Colon disease was associated with the worst overall survival.

scholarly journals PIK3CAandTP53mutations predict overall survival of stage II/III colorectal cancer patients

2018 ◽  
Vol 24 (5) ◽  
pp. 631-640 ◽  
Author(s):  
A-Jian Li ◽  
Hua-Guang Li ◽  
Er-Jiang Tang ◽  
Wei Wu ◽  
Ying Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Stage Ii ◽  
Colorectal Cancer Patients

scholarly journals Higher titer hepatitis B core antibody predicts a higher risk of liver metastases and worse survival in patients with colorectal cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ziyao Li ◽  
Shaofei Li ◽  
Hangbo Tao ◽  
Yixiang Zhan ◽  
Kemin Ni ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Hepatitis B ◽  
Liver Metastases ◽  
Cancer Patients ◽  
Hepatic Metastasis ◽  
High Titer ◽  
Poor Overall Survival ◽  
Free Survival ◽  
Colorectal Cancer Patients

Abstract Background There have been controversial voices on if hepatitis B virus infection decreases the risk of colorectal liver metastases or not. This study aims to the find the association between HBV infection and postoperative survival of colorectal cancer and the risk of liver metastases in colorectal cancer patients. Methods Patients who underwent curative surgical resection for colorectal cancer between January 2011 and December 2012 were included. Patients were grouped according to anti-HBc. Differences in overall survival, time to progress, and hepatic metastasis-free survival between groups and significant predictors were analyzed. Results Three hundred twenty-seven colorectal cancer patients were comprised of 202 anti-HBc negative cases and 125 anti-HBc positive cases, and anti-HBc positive cases were further divided into high-titer anti-HBc group (39) and low-titer anti-HBc group (86). The high-titer anti-HBc group had significantly worse overall survival (5-Yr, 65.45% vs. 80.06%; P < .001), time to progress (5-Yr, 44.26% vs. 84.73%; P < .001), and hepatic metastasis-free survival (5-Yr, 82.44% vs. 94.58%; P = .029) than the low-titer group. Multivariate model showed anti-HBc ≥ 8.8 S/CO was correlated with poor overall survival (HR, 3.510; 95% CI, 1.718–7.17; P < .001), time to progress (HR, 5.747; 95% CI, 2.789–11.842; P < .001), and hepatic metastasis-free survival (HR, 3.754; 95% CI, 1.054–13.369; P = .041) in the anti-HBc positive cases. Conclusions Higher titer anti-HBc predicts a potential higher risk of liver metastases and a worse survival in anti-HBc positive colorectal cancer patients.

Predicting biomarkers of hepatic metastasis in Chinese colorectal cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15545-e15545
Author(s):  
Honghua Peng ◽  
Tianhao Mu ◽  
Yaping Sheng ◽  
Yingmei Li ◽  
Peiguo Cao
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Hepatic Metastasis ◽  
Primary Tumor ◽  
Potential Candidate ◽  
Poor Overall Survival ◽  
Primary Tumors ◽  
Distant Spread ◽  
Colorectal Cancer Patients

e15545 Background: Hepatic metastasis is the most common site of distant spread from colorectal cancer. About 15-25% patients with colorectal cancer harbors hepatic metastasis. The molecular mechanism and predicting biomarkers in colorectal cancer are still not fully understood. Methods: 57 Chinese colorectal cancer patients were enrolled in a cohort study. Samples of primary tumor were collected in these patients and underwent whole exome sequencing. Mutation profiles of primary tumors between the patients with metastasis and those without metastasis were analyzed and compared. Results: In the cohort, 54.4% (31/57) patients presented hepatic metastasis at the time of diagnosis, while 45.6% (26/57) did not. The patients were divided into 2 groups—with hepatic metastasis and without hepatic metastasis. The mutation landscape of primary tumor indicated that the Top 3 most frequently mutated genes of both groups were the same and presented mutated TP53, APC, and KRAS. 2. Interestingly, compared with the patients without hepatic metastasis, the patients with hepatic metastasis presented a higher frequency of mutated TCF7L2 (35.5% vs 3.85%) and TRIM77 (16.1% vs 0%). Moreover, in the patients with hepatic metastasis, the patients with TRIM77 mutation in primary tumor showed a worse overall survival (p < 0.0001). Conclusions: TCF7L2 and TRIM77 may be identified as potential candidate predicting biomarkers for hepatic metastasis in colorectal patients. In addition, mutated TRIM 77 predicted a poor overall survival in hepatic metastasis from colorectal cancer.

scholarly journals A common variant of the MACC1 gene is significantly associated with overall survival in colorectal cancer patients

BMC Cancer ◽  
2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Alois H Lang ◽  
Simone Geller-Rhomberg ◽  
Thomas Winder ◽  
Nicole Stark ◽  
Klaus Gasser ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Common Variant ◽  
Colorectal Cancer Patients
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