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  • br Results br Population Demographics br The cohort consiste

    2020-08-30


    3. Results
    3.1. Population Demographics
    The cohort consisted of a total of 1361 patients with colon cancer, 683 (50.2%) of whom were aged 70 or older. The median age at diagno-sis was 70, with an interquartile range (IQR) of 62–76 years. In the younger group, the median age was 62 (IQR, 57–66 years) whereas the older group's median age was 76 (IQR, 73–80 years). Of the 683 pa-tients in the older group, 168 (24.6%) were over the age of 80. There were no statistically significant differences in demographics or baseline tumour characteristics between the two age groups. Additional demo-graphic characteristics are summarized in Table 1.
    3.2. Receipt of Chemotherapy
    Treatments received are also described in Table 1. In the entire co-hort, 1013 (74.4%) patients received adjuvant chemotherapy, of whom 504 (49.8%) received single agent and 509 (50.2%) received combina-tion regimens. In an age-group comparison, younger patients were sig-nificantly more likely to receive adjuvant chemotherapy than older patients (89.7% vs. 59.3%, p b 0.0001). Among the 1013 patients who Okadaic acid had received chemotherapy, 66% of younger patients had received com-bination therapy while only 26% of older patients had received combi-nation therapy (p b 0.0001).
    In the younger patient cohort 3 year RFS recurrence free survival was
    Table 1
    Comparing the older group of deceased patients to the younger
    Basic demographic characteristics.
    group, those who were young were significantly more likely to die
    Younger group
    colon cancer deaths, younger patients were significantly more likely to
    Age
    3.5. Analysis and Predictors of Death in Patients Aged 70 and Above
    In older patients who received chemotherapy, 168 out of 405 pa-
    Sex
    (72%) of patients who did not receive chemotherapy died in the fol-
    low-up period. Within the cohort of older patients who died (n =
    Stage
    369), those who received chemotherapy were more likely to die from
    remained the most common cause of death in patients who did not re-
    ceive chemotherapy. (Table 3). Among patients who received chemo-
    T stage
    the follow-up period, with cardiac disease being the most common
    not offered chemotherapy died of colon cancer. r> In the older patient cohort, we collected additional clinical data
    (Table 4) to analyze predictors of causes of death (colon cancer versus
    non-colon cancer). In an exploratory analysis -presence of one or
    N stage
    more comorbidities (congestive heart failure, previous cancer, COPD,
    coronary artery disease) was inversely associated with death from
    colon cancer. Another primary cancer also predictive of non-colon can-
    Chemotherapy received
    cer death.
    cancer versus non-colon cancer death in the older patient cohort using
    demographic and tumour factors. These included stage (IIIA vs IIIB vs
    stage was associated with colon cancer death (p = 0.0315). Absence of
    chemotherapy was also associated with colon cancer death (p =
    3.4. Causes of Death for Whole Cohort
    4. Discussion
    Causes of death are summarized in Table 2. Of the 601 patients in the To our knowledge, this is the first study to date to detail the causes of
    patients had a documented recurrence of their colon cancer after cura- death in a population-based cohort of adults with stage 3 colon cancer.
    tive surgery. 169 (28.1%) died of non-colon cancer causes and 15 had The strength of our database and the detailed review of medical records
    unknown cause of death. Among the non-colon cancer deaths, other allowed us to capture causes of death that may have been misclassified
    primary cancers (46; 27.2%), cardiac disease including myocardial in- when simply using data obtained from death certificates. This study un-
    farction and heart failure (45; 26.6%), neurologic disorder which in- derscores the fact that older patients remain under-treated with che-
    cludes dementia and other neurogenerative diseases (18; 10.7%), motherapy relative to their younger counterparts. We also
    strokes (14; 8.3%), and infections (11, 6.5%) were the most prevalent demonstrate that older patients were likely to die from non-colon can-
    causes of death. Death that could be ascribed directly to receipt of che- cer causes, such as heart disease and neurologic events.
    motherapy occurred in 2 patients, both of whom had aspiration pneu- Multiple large studies have demonstrated that older patients derive
    monia. These were categorized as “other”.
    similar benefit from adjuvant chemotherapy compared to younger pa-