Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer: the DISCO study

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Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer : the DISCO study. / Lund, Cecilia M.; Vistisen, Kirsten K.; Dehlendorff, Christian; Rønholt, Finn; Johansen, Julia S.; Nielsen, Dorte L.

In: Acta Oncologica, Vol. 57, No. 11, 2018, p. 1445-1454.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Lund, CM, Vistisen, KK, Dehlendorff, C, Rønholt, F, Johansen, JS & Nielsen, DL 2018, 'Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer: the DISCO study', Acta Oncologica, vol. 57, no. 11, pp. 1445-1454. https://doi.org/10.1080/0284186X.2018.1531299

APA

Lund, C. M., Vistisen, K. K., Dehlendorff, C., Rønholt, F., Johansen, J. S., & Nielsen, D. L. (2018). Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer: the DISCO study. Acta Oncologica, 57(11), 1445-1454. https://doi.org/10.1080/0284186X.2018.1531299

Vancouver

Lund CM, Vistisen KK, Dehlendorff C, Rønholt F, Johansen JS, Nielsen DL. Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer: the DISCO study. Acta Oncologica. 2018;57(11):1445-1454. https://doi.org/10.1080/0284186X.2018.1531299

Author

Lund, Cecilia M. ; Vistisen, Kirsten K. ; Dehlendorff, Christian ; Rønholt, Finn ; Johansen, Julia S. ; Nielsen, Dorte L. / Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer : the DISCO study. In: Acta Oncologica. 2018 ; Vol. 57, No. 11. pp. 1445-1454.

Bibtex

@article{28c1c7139ad94bf785851a60e7cc6cec,
title = "Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer: the DISCO study",
abstract = "Objectives: First-line chemotherapy for metastatic colorectal cancer (mCRC) is effective and feasible in selected older patients. We investigated age-dependent differences in treatment and outcomes in patients with mCRC in clinical practice. Material and methods: A retrospective study of 654 patients with mCRC referred to first-line chemotherapy in 2008–2014. Patients were divided into two age groups: 50–69 and ≥70 (older patients). Binary outcomes were analyzed by logistic regression. Progression-free survival (PFS) and overall survival (OS) were analyzed by Cox proportional hazards regression, CRC-specific and other-cause mortality with Fine and Gray proportional hazard model for the sub-distribution of a competing risk. Results: After adjusting for performance status (PS) and comorbidity, older patients were more likely to receive monotherapy (adjusted odds ratio (aOR) = 9.00, 95% confidence interval (CI) 4.52–17.91), lower doses, and no additional targeted therapy (aOR = 1.89, 95% CI 1.28–2.78) than younger patients. Yet, older patients experienced more toxicity and hospitalizations (aOR = 1.53, 95% CI 1.08–2.17). Among those treated, older patients had shorter PFS (hazard ratio (HR) = 1.32, 95% CI 1.11–1.57), but after adjusting for PS and comorbidity, PFS was similar. No significant difference was found in CRC mortality (HR = 1.15, 95% CI 0.95–1.40) between age groups. Poor PS was associated with shorter OS and PFS and higher CRC mortality. Conclusions: In the DISCO study, older patients with mCRC received less aggressive first-line chemotherapy. Yet, they experienced more toxicity. Younger and older patients had similar CRC mortality. Shorter PFS and higher CRC mortality were observed in patients with poor PS.",
author = "Lund, {Cecilia M.} and Vistisen, {Kirsten K.} and Christian Dehlendorff and Finn R{\o}nholt and Johansen, {Julia S.} and Nielsen, {Dorte L.}",
year = "2018",
doi = "10.1080/0284186X.2018.1531299",
language = "English",
volume = "57",
pages = "1445--1454",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Taylor & Francis",
number = "11",

}

RIS

TY - JOUR

T1 - Age-dependent differences in first-line chemotherapy in patients with metastatic colorectal cancer

T2 - the DISCO study

AU - Lund, Cecilia M.

AU - Vistisen, Kirsten K.

AU - Dehlendorff, Christian

AU - Rønholt, Finn

AU - Johansen, Julia S.

AU - Nielsen, Dorte L.

PY - 2018

Y1 - 2018

N2 - Objectives: First-line chemotherapy for metastatic colorectal cancer (mCRC) is effective and feasible in selected older patients. We investigated age-dependent differences in treatment and outcomes in patients with mCRC in clinical practice. Material and methods: A retrospective study of 654 patients with mCRC referred to first-line chemotherapy in 2008–2014. Patients were divided into two age groups: 50–69 and ≥70 (older patients). Binary outcomes were analyzed by logistic regression. Progression-free survival (PFS) and overall survival (OS) were analyzed by Cox proportional hazards regression, CRC-specific and other-cause mortality with Fine and Gray proportional hazard model for the sub-distribution of a competing risk. Results: After adjusting for performance status (PS) and comorbidity, older patients were more likely to receive monotherapy (adjusted odds ratio (aOR) = 9.00, 95% confidence interval (CI) 4.52–17.91), lower doses, and no additional targeted therapy (aOR = 1.89, 95% CI 1.28–2.78) than younger patients. Yet, older patients experienced more toxicity and hospitalizations (aOR = 1.53, 95% CI 1.08–2.17). Among those treated, older patients had shorter PFS (hazard ratio (HR) = 1.32, 95% CI 1.11–1.57), but after adjusting for PS and comorbidity, PFS was similar. No significant difference was found in CRC mortality (HR = 1.15, 95% CI 0.95–1.40) between age groups. Poor PS was associated with shorter OS and PFS and higher CRC mortality. Conclusions: In the DISCO study, older patients with mCRC received less aggressive first-line chemotherapy. Yet, they experienced more toxicity. Younger and older patients had similar CRC mortality. Shorter PFS and higher CRC mortality were observed in patients with poor PS.

AB - Objectives: First-line chemotherapy for metastatic colorectal cancer (mCRC) is effective and feasible in selected older patients. We investigated age-dependent differences in treatment and outcomes in patients with mCRC in clinical practice. Material and methods: A retrospective study of 654 patients with mCRC referred to first-line chemotherapy in 2008–2014. Patients were divided into two age groups: 50–69 and ≥70 (older patients). Binary outcomes were analyzed by logistic regression. Progression-free survival (PFS) and overall survival (OS) were analyzed by Cox proportional hazards regression, CRC-specific and other-cause mortality with Fine and Gray proportional hazard model for the sub-distribution of a competing risk. Results: After adjusting for performance status (PS) and comorbidity, older patients were more likely to receive monotherapy (adjusted odds ratio (aOR) = 9.00, 95% confidence interval (CI) 4.52–17.91), lower doses, and no additional targeted therapy (aOR = 1.89, 95% CI 1.28–2.78) than younger patients. Yet, older patients experienced more toxicity and hospitalizations (aOR = 1.53, 95% CI 1.08–2.17). Among those treated, older patients had shorter PFS (hazard ratio (HR) = 1.32, 95% CI 1.11–1.57), but after adjusting for PS and comorbidity, PFS was similar. No significant difference was found in CRC mortality (HR = 1.15, 95% CI 0.95–1.40) between age groups. Poor PS was associated with shorter OS and PFS and higher CRC mortality. Conclusions: In the DISCO study, older patients with mCRC received less aggressive first-line chemotherapy. Yet, they experienced more toxicity. Younger and older patients had similar CRC mortality. Shorter PFS and higher CRC mortality were observed in patients with poor PS.

U2 - 10.1080/0284186X.2018.1531299

DO - 10.1080/0284186X.2018.1531299

M3 - Journal article

C2 - 30375911

AN - SCOPUS:85055752576

VL - 57

SP - 1445

EP - 1454

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 11

ER -

ID: 215509068