Approximately 50 percent of elderly patients who have advanced, but not metastatic, colon cancer do not get chemotherapy after surgery. But a new statistics-based study by Columbia Health Sciences researchers reveals that elderly people with colon cancer live longer when they receive both types of treatment.

In the study, the investigators found that patients 65 years and older with colon cancer that had spread to the lymph nodes and treated with both the drug 5-fluorouracil (5-FU) and surgery had a 30 percent reduction in mortality at five years after diagnosis compared with individuals who received surgery alone. The increased longevity is similar to what patients under age 65 realize with both therapies. This year, approximately 43,000 people will get node-positive colon cancer, two-thirds of whom are older than 65.

The study used statistical methods to analyze data from the National Cancer Institute for 4,768 patients who were at least 65 years old and who received a diagnosis of colon cancer with lymph node involvement between 1992 and 1996. Approximately half received surgery and the other half surgery and 5-FU. The mortality rate for those who received surgery alone was approximately 50 percent to 60 percent at five years, as compared with approximately 30 percent to 40 percent for those who received both treatments.

These and other comparable studies should allow doctors and patients to make better decisions about treatment for colon cancer, the researchers say. Age should not be a deterrent for doctors and patients making the decision to treat someone with both surgery and chemotherapy, says Dr. Alfred I. Neugut, principal investigator of the study and professor of medicine at Columbia University College of Physicians & Surgeons (P&S) and epidemiology at the Mailman School of Public Health and co-director of the Cancer Prev
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Contact: Annie Bayne
as862@columbia.edu
Columbia University Medical Center
20-May-2002

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