P-281 Colon cancer in elderly patients: Experience of the Medical Oncology Department of CHU Hassan II Fez

Abstract

This is a retrospective study of patients over the age of 70 with colonic cancer who were followed up and treated in the Department of Medical Oncology at Hassan II University Hospital in Fez from January 2015 to June 2019. Overall, 15.38% of patients aged over 70 years were listed among the 247 cases of histologically confirmed colon cancer collected over a period of 4 years. The median age was 79.44 years (range, 70-103 years), with a slight male predominance of 57%. In all, 28% of patients had hypertension-type comorbidities and diabetes, and only 1 patient had well-controlled prostate cancer under medical castration. Colonic adenocarcinoma was the histological type in all cases. Overall, 65% of patients were metastatic with a predilection for the liver and the lungs as sites of metastasis. RAS status was sought only in 7.69% of cases and was mutated. A total of 23.07% of patients had received mono-chemotherapy based on intravenous or oral fluoropyrimidines; 53.84% received bi-chemotherapy based on 5FU in combination with irionotecan or oxaliplatin; and 61.53% received bevacizumab in combination with chemotherapy. In all, 8.69% of patients were put on maintenance after a partial response to the first line of treatment with good tolerance. Only 19.23% were able to receive a second therapeutic line. Overall, 11.53% were lost to follow-up after diagnosis and 11.53% who had a PS of 4 were placed in supportive care. Of the patients, 31.57% were operated without any postoperative complications. One-quarter were classified as stage II with the achievement of microsatellite status, which was stable in 66.6% and unstable in 33.3%. Overall, 45.45% had received 5FU bi-chemotherapy whereas 36.36% had received only a mono-chemotherapy. Of the patients who received adjuvant chemotherapy, 22.2% are currently under good control. The safety profile was generally good without any grade 3 or 4 toxicity. The treatment of elderly patients with colon cancer remains similar to that of young people. However, their treatment must be adapted according to their physiological conditions and their comorbidities within the framework of a multidisciplinary collaboration for a better quality of life.