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Treatment of colorectal cancer in the elderly

World Journal of Gastrointestinal Oncology 2015年第10期7卷 204-220页

作者： Monica Millan Sandra Merino Aleidis Caro Francesc Feliu Jordi Escuder Tani Francesch Colorectal Surgery Unit Department of Surgery Joan XXIII University Hospital Department of Medical Oncology Joan XXIII University Hospital and St. Joan de Reus University Hospital Department of Geriatrics and Palliative Care Joan XXIII University Hospital (GiPSS)

Colorectal cancer has a high incidence, and approxi-mately 60% of colorectal cancer patients are older than 70, with this incidence likely increasing in the near future. Elderly patients(> 70-75 years of age) are a very heterogeneous group, ranging from the very fit to the very frail. Traditionally, these patients have often been under-treated and recruited less frequently to clinical trials than younger patients, and thus are underrepresented in publications about cancer treatment. Recent studies suggest that fit elderly patients can be treated in the same way as their younger counterparts, but the treatment of frail patients with comorbidities is still a matter of controversy. Many factors should be taken into account, including fitness for treatment, the wishes of the patient and family, and quality of life. This review will focus on the existing evidence for surgical, oncologic, and palliative treatment in patients over 70 years old with colorectal cancer. Careful patient assessment is necessary in order to individualize treatment approach, and this should rely on a multidisciplinary process. More well-designed controlled trials are needed in this patient population.

关键词： Colorectal cancer Surgery Chemotherapy radiotherap

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