A Sustained Complete Response in an Elderly Patient with Metastatic Colorectal Adenocarcinoma—A Clinical Case
- 1 Medical Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
- 2 Medical Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
- 3 Medical Oncology Department, Portuguese Institute of Oncology of Porto, Porto, Portugal
Abstract
Background: The increasing life expectancy of people worldwide will signify that oncologists everywhere will be faced with many difficult decisions regarding treatment options in the elderly population with cancer. These patients carry specific challenges that should be discussed. Aim: To report the clinical case of an elderly patient with a metastatic colorectal cancer with a sustained complete response and reflect on the particularities on this special population. Clinical case: In 2009 , an 80-year-old man presents with colorectal cancer, undergoes surgery and intraoperatively a peritoneal implant is resected. He is deemed fit for chemotherapy and is treated with 8 cycles of capecitabine. After a 10-year follow-up, he remains with no evidence of disease. Conclusion: Chronological age is insufficient to establish a treatment plan; oncologists must evaluate the patient multidimensionally and develop personalized options for the therapy and follow-up of older individuals.
- Siegel, R.L., et al. (2018) Cancer Statistics, 2018. CA: A Cancer Journal for Clinicians, 68, 7-30. https://doi.org/10.3322/caac.21442
- National Cancer Institute. Surveillance, Epidemiology, and End Results Program: SEER Fact Sheets—Colon and Rectum Cancer. http://seer.cancer.gov/statfacts/html/colorect.html
- McCleary, N.J., Dotan, E. and Browner, I. (2014) Refining the Chemotherapy Approach for Older Patients with Colon Cancer. Journal of Clinical Oncology, 32, 2570-2580. https://doi.org/10.1200/JCO.2014.55.1960
- Gross, C.P., Guo, Z., McAvay, G.J., Allore, H.G., Young, M. and Tinetti, M.E. (2006) Multimorbidity and Survival in Older Persons with Colorectal Cancer. Journal of the American Geriatrics Society, 54, 1898-1904. https://doi.org/10.1111/j.1532-5415.2006.00973.x
- NCCN Guidelines in Older Adult Oncology, Version 2.2020.
- Cockcroft, D.W. and Gault, M.H. (1976) Prediction of Creatinine Clearance from Serum Creatinine. Nephron, 16, 31-41. https://doi.org/10.1159/000180580
- Franko, J., et al. (2016) Prognosis of Patients with Peritoneal Metastatic Colorectal Cancer Given Systemic Therapy: An Analysis of Individual Patient Data from Prospective Randomised Trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) Database. The Lancet Oncology, 17, 1709-1719. https://doi.org/10.1016/S1470-2045(16)30500-9
- Goldberg, R.M., et al. (2006) Pooled Analysis of Safety and Efficacy of Oxaliplatin plus Fluorouracil/Leucovorin Administered Bimonthly in Elderly Patients with Colorectal Cancer. Journal of Clinical Oncology, 24, 4085-4091. https://doi.org/10.1200/JCO.2006.06.9039
- McCleary, N.J., et al. (2013) Impact of Age on the Efficacy of Newer Adjuvant Therapies in Patients with Stage II/III Colon Cancer: Findings from the Accent Database. Journal of Clinical Oncology, 31, 2600-2606.
- Yothers, G., et al. (2011) Oxaliplatin as Adjuvant Therapy for Colon Cancer: Updated Results of NSABP C-07 Trial, Including Survival and Subset Analyses. Journal of Clinical Oncology, 29, 3768-3774. https://doi.org/10.1200/JCO.2011.36.4539
- Tournigand, C., et al. (2012) Adjuvant Therapy with Fluorouracil and Oxaliplatin in Stage II and Elderly Patients (between Ages 70 and 75 Years) with Colon Cancer: Subgroup Analyses of the Multicenter International Study of Oxaliplatin, Fluorouracil, and Leucovorin in the Adjuvant Treatment of Colon Cancer Trial. Journal of Clinical Oncology, 30, 3353-3360. https://doi.org/10.1200/JCO.2012.42.5645