Consideration of therapeutic approach to advanced colorectal cancer in elderly patients

Yasuhiro Yasuhiro Inoue,Masato Kusunoki,Yasuhiko Mohri,Koji Tanaka,Yuji Toiyama

doi:10.14319/ijcto.0201.4

Abstract

Colorectal cancer (CRC) is predominantly a disease of elderly and is a major cause of morbidity and mortality in the elderly population. The increased availability of treatment options for CRC has made it more difficult for clinicians to decide on the optimal therapeutic approach in elderly patients, because of the potential for poorer outcomes due to an increased burden of comorbidities, functional dependency, and limited life expectancy. It is necessary to determine which elderly patients are likely to benefit from active cancer therapy, and the establishment of treatment markers for multimodality approaches is eagerly awaited. Elderly cancer patients are at risk of exposure to various intrinsic inflammatory mediators, such as tumor-generating cytokines and surgery-induced pro-inflammatory cytokines. It is therefore important to understand the immunological changes occurring in the elderly and to adjust treatment strategies accordingly to reduce the morbidity and mortality associated with multimodality therapy for CRC that induce systemic inflammation. Several inflammation-based factors such as the Glasgow Prognostic Score (GPS) may reflect the balance between tumor progression and host-related immunity, especially in elderly CRC patients. Appropriate selection criteria for multimodality therapy in elderly CRC patients may include not only tumor characteristics, but also host- and/or treatment-related factors such as comorbidities or surrogate markers using inflammation-based factors. ---------------------------------------------- Cite this article as: Inoue Y, Toiyama Y, Tanaka K, Mohri Y, Kusunoki M. Consideration of therapeutic approach to advanced colorectal cancer in elderly patients. Int J Cancer Ther Oncol 2014; 2(1):02014. DOI: http://dx.doi.org/10.14319/ijcto.0201.4

Highlights

The elderly population is increasing rapidly in developed countries, and cancer remains a major public health problem affecting more elderly than younger individuals
Various treatment modalities have been used to prolong survival in patients with Colorectal cancer (CRC), including surgery, radiotherapy and chemotherapy, and this multimodal thera
The reasons why elevated C-reactive protein (CRP) correlates with poor long-term outcome in cancer patients is not fully understood, several pro-inflammatory cytokines expressed in the tumor environment, such as interleukin-1(IL-1), IL-6, and tumor necrosis factor-α, may affect the malignant potential of tumor cells.[5]

Summary

Introduction

The elderly population is increasing rapidly in developed countries, and cancer remains a major public health problem affecting more elderly than younger individuals. Various treatment modalities have been used to prolong survival in patients with CRC, including surgery, radiotherapy and chemotherapy, and this multimodal thera-

Results

Conclusion