ADJUVANT TREATMENT IN ELDERLY CANCER PATIENTS: A MULTICENTER REAL-LIFE EXPERIENCE

BACKGROUND. Elderly cancer patients are frequently underrepresented in clinical trials. Therefore standardized approaches to treat these subjects lack. Survival is further limited in elderly patients, who are often unable to tolerate aggressive regimens. Purpose of our work is to describe the patterns of care of elderly cancer patients as well as reporting resulting survival outcomes in a multicenter real-life experience. MATERIALS AND METHODS We conducted a retrospective analysis of 358 consecutive patients aged ³75 years with nonmetastatic cancer who received an adjuvant treatment at Sant’Andrea Hospital in Rome and San Camillo de Lellis Hospital in Rieti. RESULTS. Median age at diagnosis was 77 years. At the histological breast (65.6%) and colorectal (22.3%) cancer were the most represented ones. Comorbidities emerged in 80% of patients not resulting in a significant correlation with disease free survival (DFS) [Hazard ratio (HR), 1.1; (95% confidence interval [CI], 0.72-1.71); p=0.63]. We didn’t report any association between increased age and adverse events on chemotherapy. Risk analysis for DFS showed that female gender (HR,0.53; 95% CI, 0.37-0.78; p=0.001) and a better performance status (PS) according to ECOG scale (PS1 vs PS0: HR,1.60; 95% CI, 1.08-2.34; p=0.02 and PS2 vs PS0: HR, 3.31; 95% CI, 1.32-8.28; p=0.01) had a significant lower risk for replace or death. Increased age (HR, 1.1; 95% CI, 1.07-1.16; p<0.0001) and colorectal (CR) cancer (HR, 2.39;95%CI, 1.58-3.59; p<0.0001) were associated with a shorter DFS. CONCLUSIONS. This real-life multicenter experience identified four (gender, PS, age, CR histology) prognostic factors among elderly patients who received an adjuvant treatment. Prospective trials are necessary to select and customize chemotherapy in this group of patients