A population-based study of metastatic colorectal cancer (mCRC) in people age 80 or older: Findings from the South Australian Clinical Registry (SACR) for mCRC.

Abstract

9082 Background: Life expectancy is increasing and more patients (pts) with mCRC are presenting at an advanced age (>80). Optimal management approach for this group of pts is not well defined as they are under-represented in clinical trials. Methods: The SACR for mCRC collects data on mCRC pts diagnosed after 1/2/2006. We examined cancer characteristics, treatment and outcome for pts aged >80 yrs. Comparison was made with pts <80 yrs. Results: Data from 1,878 eligible mCRC pts has been entered to date. 559 (30%) of these pts were aged ≥ 80. Key pt characteristics and treatments are reported in the table. Grade 3 differentiation was reported in lower proportion of pts ≥80 yrs than the younger group (18.4 % vs. 26.3 %, p < 0.001). Only 25% of pts >80 received chemotherapy (CT). Of these, 67% received single agent CT (mostly capecitabine) while 33% received combination CT as first line treatment. In comparison, 69% of pts <80 had CT, 75% of which received combination and 25% single agent (majority capecitabine) as their first line CT. Pts ≥ 80 had fewer liver resections, were less likely to receive radiotherapy or monoclonal antibodies and had lower recruitment in clinical trials. Median survival (MS) was 7.9 mths for >80 yrs vs. 19.6 mths for <80 yrs; p < 0.001. MS for pts treated with CT was 20 mths for >80 and 23 mths for <80, p = 0.127. Pts without any treatment had a poor survival regardless of their age (MS 2.9 mths >80 yrs vs. 3.4 mths <80 yrs). Conclusions: Older pts (≥ 80 yrs) were less likely to receive intervention for their mCRC and had poorer survival. However, survival for selected elderly pts, who received CT, was similar to those <80, despite most receiving single agent therapy. Patient characteristics and treatments. (<80 yrs) n = 1,319 (≥80 yrs) n = 559 Median age (range) 67 (17-79) 85 (80–105) Sex—M/F 799 (60%)/520 (40%) 272 (49%)/287 (51%) Synchronous primary 867 (66%) 339 (61%) Rectal primary 364 (28%) 113 (20%) Liver only metastatic site 540 (41%) 199 (36%) ≥3 metastatic sites 112 (8.5%) 48 (9%) Liver resections 213 (16%) 34 (6%) Surgery 753 (57%) 232 (41.5%) Monoclonal antibody 169 (13%) 11 (2%) Radiotherapy 263 (20%) 42 (7.5%) No treatment 156 (12%) 221 (39.5%)