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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 1/2024

01-12-2024 | Colorectal Cancer | RESEARCH

Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study

Authors: Tomoaki Bekki, Manabu Shimomura, Yasufumi Saito, Masahiro Nakahara, Tomohiro Adachi, Satoshi Ikeda, Yosuke Shimizu, Masatoshi Kochi, Yasuyo Ishizaki, Masanori Yoshimitsu, Yuji Takakura, Wataru Shimizu, Daisuke Sumitani, Shinya Kodama, Masahiko Fujimori, Mamoru Oheda, Hironori Kobayashi, Shintaro Akabane, Takuya Yano, Hideki Ohdan

Published in: International Journal of Colorectal Disease | Issue 1/2024

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Abstract

Purpose

Adjuvant chemotherapy is recommended following colorectal cancer resection based on risk of recurrence. In older patients, treatment decisions should consider recurrence rates and tolerability, as well as functional prognosis, residual disease, and social factors. This study aims to investigate factors, including social background, influencing implementation of postoperative adjuvant chemotherapy in older patients undergoing curative resection for colorectal cancer.

Methods

This multi-institutional prospective cohort study included 15 institutions belonging to the Hiroshima Surgical study group for Clinical Oncology. We analyzed 159 older patients aged ≥ 80 years, who underwent curative resection for stage III colorectal cancer between December 2013 and June 2018, as sub-analysis of the HiSCO-04 study.

Results

In total, 62 (39.0%) patients underwent postoperative adjuvant chemotherapy. Four factors were significantly associated with its implementation: performance status < 2, Charlson Comorbidity Index < 2, prognostic nutritional index ≥ 40, and presence of a spouse or siblings as lifestyle supporters. No significant difference was found in the backgrounds between complete and incomplete postoperative adjuvant chemotherapy patients.

Conclusion

Performance status, Charlson Comorbidity Index, nutritional status, and presence of a spouse or siblings as lifestyle supporters are possible factors influencing the implementation of postoperative adjuvant chemotherapy in older patients. To select appropriate treatment options, including postoperative adjuvant chemotherapy, it is essential to consider physical condition and comorbidities of older patients, thoroughly explain the situation to their families, and establish a support system to enhance understanding of the available treatment options.
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Metadata
Title
Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study
Authors
Tomoaki Bekki
Manabu Shimomura
Yasufumi Saito
Masahiro Nakahara
Tomohiro Adachi
Satoshi Ikeda
Yosuke Shimizu
Masatoshi Kochi
Yasuyo Ishizaki
Masanori Yoshimitsu
Yuji Takakura
Wataru Shimizu
Daisuke Sumitani
Shinya Kodama
Masahiko Fujimori
Mamoru Oheda
Hironori Kobayashi
Shintaro Akabane
Takuya Yano
Hideki Ohdan
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 1/2024
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-023-04583-7

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