No Difference in Chemotherapy Benefits for Young Patients with Stage II and III Colon Cancer Compared to Those Fifty and Older

Young patients with stage II or III colon cancer get equal benefit from chemotherapy as older patients, and they have similar side effects.

Five years after treatment, 67 percent of patients under the age of fifty hadn’t had their cancer spread beyond the colon (recurrence-free interval), the same percentage that applied to patients who were fifty or over.

Overall survival and disease-free survival were somewhat better for young patients because they had fewer other reasons for dying.  Overall and disease-free survival reflect patients who are alive five years after beginning treatment.  Neither includes people who have died from any cause, including their cancer.

Researchers from the ACCENT Collaborative Group in cooperation with the LIVESTRONG Young Adult Alliance analyzed information from 33,574 individual colon cancer patients who took part in 24 different randomized Phase III clinical trials.

  • 1,758 or 5.2 percent were under age 40
  • 5,817 or 17.3 percent were under age 5o
  • 299 or 0.9 percent were under age 30

Comparing outcomes at 5 years:

  • Overall survival was 75 percent for those younger than 40, 76 percent for those under 50, and 71 percent for those 50 and over.
  • Disease free survival was 68 percent for patients under 40, 68 percent for those under 50, and 61 percent for 50 and over.
  • Five year recurrence-free intervals were experienced by 68 percent under 40, 67 percent under 50, and 67 percent 50 and older.

There were no clinically meaningful differences in serious side effects between younger and older patients.

Mayo Clinic biostatistican, Daniel J. Sargent, PhD, and his team concluded,

Among patients on chemotherapy, young (age 30-50) stage II and III CC patients had similar recurrence-free interval and adjuvant chemotherapy benefit as older patients, with no clinically meaningful differences in adverse events. Young patients have improved overall survival and disease-free survival, likely primarily due to fewer competing causes of death. Adjuvant chemotherapy is beneficial for colon cancer patients aged 30-50 meeting typical chemotherapy eligibility criteria.

SOURCE: Sargent et al., 2010 ASCO Annual Meeting Abstracts, Abstract #3523.

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