Adjuvant Chemotherapy Among Elderly Colon Cancer Patients : from gut feeling towards evidence-based use in clinical practice

Elderly represent a substantial part of the colon cancer patients and this will increase even further in the near future due to demographic developments. This thesis provides a substantial contribution to the limited available evidence on the use and effectiveness of adjuvant chemotherapy among unselected elderly patients with stage III colon cancer treated in everyday clinical practice. It was shown that elderly derive comparable benefit from adjuvant chemotherapy as their younger counterparts, indicating that consideration of adjuvant chemotherapy is warranted for all patients. It was also shown that capecitabine monotherapy is better tolerated and less toxic, without limiting the recurrence-free and overall survival benefit, compared to a combination of capecitabine and oxaliplatin. Therefore, the addition of oxaliplatin should not be standard care for the majority of elderly stage III colon cancer patients treated in daily clinical practice.