Survival Outcomes of Elderly Patients with Stage III Colon Cancer: Insights from a Comprehensive Cancer Center in the Middle East
Background: Colon cancer is the fourth most commonly diagnosed cancer worldwide, with elderly individuals accounting for nearly one-third of new cases. While adjuvant chemotherapy has been associated with improved survival outcomes; its effectiveness in elderly patients remains unclear. This retrospective study was conducted to assess the efficacy of adjuvant chemotherapy in elderly patients with stage 3 colon cancer. Methods: We identified all patients aged 70 years or older with stage 3 colon cancer who were treated and followed at King Hussein Cancer Center (KHCC) in Amman, Jordan between 2015 and 2020. Intramural KHCC funding was granted for MMR testing in patients who received adjuvant chemotherapy. Descriptive and survival analyses were performed in JASP 0.95.4 software. Results: A total of 66 patients were included. The median age at diagnosis was 73 years, and 39.3% were females. 74.2% had T3 tumors, and 69.6% had N1 disease. Adjuvant chemotherapy was administered to 71.2% (n=47) of patients, including 14 with deficient MMR status. Five-year overall survival (OS) favored patients treated with adjuvant chemotherapy compared with those who did not, although the difference was not statistically significant (80.3% vs 71.9%; HR 0.71, 95% CI 0.23–2.16; P = 0.538). Among patients treated with adjuvant chemotherapy, 5-year OS was 83.4% with Oxaliplatin-doublet therapy versus 70.7% with single-agent 5-FU based therapy (HR 0.59, 95% CI 0.14-2.44; P = 0.460). Additionally, there was no significant OS difference observed between different chemotherapy regimens after stratification by MMR status (P = 0.271). Conclusions: In this single-center cohort, adjuvant chemotherapy demonstrated a non-significant trend toward improved overall survival among elderly patients with stage III colon cancer; however, interpretation was limited by the small sample size.