A RETROSPECTIVE STUDY OF AGEING PATIENTS WITH GASTROINTESTINAL CANCER TREATED BETWEEN 2014-2018

Introduction: Data from GLOBOCAN estimate more than 6 million of cancer patients older ≥ to 70 years. As the elderly population is poorly represented in clinical studies, it becomes important to know how these patients are treated. Objective: To evaluate the treatment of patients ≥ 70 years with Gastrointestinal Cancer (GIC) in a University public hospital. Method: We retrospectively included patients treated between 2014-18, with diagnosis of GIC aged ≥ 70 years by electronic medical record . Tumor localization, stage, histological type and treatment including chemotherapy (CT) were studied. Results: We included 71 patients (mean age of 79 years). Adenocarcinoma was the most frequent histological type (31 had colorectal cancer, 18 gastric, 7 pancreas, 4 duodenal papilla and 1 esophagus), 4 had GIST, 3 squamous cell carcinoma of the esophagus and 3 of the anal cancer. Colon: 4 stage IV were treated with CT with fluoropyrimidine and oxaliplatin (3 received 7 and one 14 cycles of XELOX with subsequent treatment change due to disease progression -DP). Stage I-III tumors were submitted to surgery and adjuvant CT indicated in 8 of 9 patients. XELOX was initiated in 3, with posterior withdrawal of oxaliplatin by toxicity and in the others only fluoropyrimidines was prescribed. Rectum: 1 stage IV treated with FLOX, 10 did neoadjuvant chemoradiotherapy (CRT) with posterior surgery, 6 went neoadjuvant CRT without surgery by DP/PS (performance status), 9 did adjuvant CT with capecitabine (2 cycles). Gastric: 5 were stage IV, 4 received CT with FLOX, EOX and Taxol (4 cycles) and 1 receive BSC;9 were submitted to surgery, and in 6 adjuvant CT with XELOX, FOLFOX or CRT was indicated, only 1 completed all the treatment. Esophagus: 2 were treated with CRT, 1 receive CT and had DP during the treatment and 1 receive BSC by poor PS. Duodenal papilla: 2 received adjuvant gemcitabine (5 cycles), 1 palliative CT with FLOX and 1 only BSC. Pancreas: 2 had surgical resection (both PD after, not performing adjuvant), 5 were unresectable (1 BSC and 4 treated with mean of 7 cycles of gemcitabine until DP/poor PS). GIST: 1 unfavorable outcome in one whose histology was high grade, 3 treating with Imatinib. Anal cancer: 1 treated with CRT, 1 stage IV treated with capecitabine, and one BSC. Conclusion: 16 had metastatic disease at diagnosis and 5 received only BSC. The analysis of this subgroup of patients is necessary to elaboration of hypotheses regarding the tolerability of CT.

Publication History

Article published online:
23 October 2019