Langheinrich, M. and Gerken, Michael and Robers, Gabriele and Hansinger, Judith and Franke, B. and Lacruz, M. E. and Mueller-Nordhorn, J. and Schneider, C. and Reinwald, F. and Stang, A. and Sackmann, A. and Zeissig, S. R. and Klinkhammer-Schalke, Monika and Kersting, S. and Voelkel, V. and Benz, S. (2025) Survival benefit of adjuvant chemotherapy in elderly patients with UICC stage III colon carcinoma: A 20-year population-based German cohort study. EUROPEAN JOURNAL OF CANCER, 227: 115583. ISSN 0959-8049, 1879-0852
Full text not available from this repository. (Request a copy)Abstract
Background: In UICC stage III colon cancer, guidelines recommend adjuvant chemotherapy. However, specific recommendations for elderly patients remain inconsistent, partly due to their under-representation in randomized trials. This results in a gap between trial populations and the broader patient population, making it difficult to draw conclusions about the benefits of chemotherapy for older patients in clinical routine. Methods: Based on an anonymized and aggregated population-based dataset from German clinical cancer registries (ADT), 41,630 patients with UICC stage III colon cancer were identified between 2000 and 2020. Patients were classified by age (<75 vs. >= 75 years) and whether they received adjuvant chemotherapy. Survival rates were compared using Kaplan-Meier estimates and univariable/multivariable Cox regression analyses. Results: Overall, 50.2 % (n = 20,906) received adjuvant chemotherapy. Among patients >= 75 years, only 28.2 % were treated, compared to 64.0 % of younger patients. The overall share of patients receiving oxaliplatin-based chemotherapy regimens was 45.7 % over the entire study period. Among elderly patients, the use of oxaliplatinbased regimens increased from 11.6 % in 2000-2007-22.0 % in 2016-2020. The mean time from surgery to chemotherapy initiation was similar across age groups (similar to 6 weeks). In elderly patients, 5-year overall survival (OS) was 62.0 % (95 %-CI 60.5-63.5 %) with chemotherapy vs. 41.8 % (95 %-CI 40.9-42.8 %) without. Multivariable Cox regression confirmed a significant OS benefit (HR 0.677; 95 %-CI 0.646-0.710; p < 0.001) and recurrence-free survival benefit (HR 0.714; 95 %-CI 0.682-0.748; p < 0.001). Conclusion: This large population-based study reveals marked age-related disparities in the use of adjuvant chemotherapy in UICC stage III colon cancer. Despite lower treatment rates, elderly patients derive substantial survival benefit, supporting careful consideration of adjuvant chemotherapy in patients aged 75 years and older.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OLDER PATIENTS; CANCER; FLUOROURACIL; LEUCOVORIN; Colon cancer; Adjuvant chemotherapy; Elderly patients; UICC Stage III colon cancer; Real-world data; Population-based study; Clinical cancer registries; Treatment outcomes; Geriatric Oncology |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Apr 2026 11:53 |
| Last Modified: | 20 Apr 2026 11:53 |
| URI: | https://pred.uni-regensburg.de/id/eprint/67618 |
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