TY - JOUR
T1 - Association of age with survival in patients with metastatic colorectal cancer
T2 - Analysis from the ARCAD clinical trials program
AU - Lieu, Christopher H.
AU - Renfro, Lindsay A.
AU - De Gramont, Aimery
AU - Meyers, Jeffrey P.
AU - Maughan, Timothy S.
AU - Seymour, Matthew T.
AU - Saltz, Leonard
AU - Goldberg, Richard M.
AU - Sargent, Daniel J.
AU - Eckhardt, S. Gail
AU - Eng, Cathy
N1 - Publisher Copyright:
© 2014 by American Society of Clinical Oncology.
PY - 2014/9/20
Y1 - 2014/9/20
N2 - Purpose: This study addressed whether age is prognostic for overall survival (OS) or progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC).Patients and Methods: A total of 20,023 patients from 24 first-line clinical trials in the ARCAD (Aide et Recherche en Cancé rologie Digestive) database were analyzed. Primary age effects and interactions with age, sex, performance status (PS), and metastatic site were modeled using Cox proportional hazards stratified by treatment arm within study.Results: Of total patients, 3,051 (15%) were age ≤ 50 years. Age was prognostic for both OS (P < .001) and PFS (P < .001), with U-shaped risk (ie, highest risk was evident in youngest and oldest patients). Relative to patients of middle age, the youngest patients experienced 19% (95% CI, 7% to 33%) increased risk of death and 22% (95% CI, 10% to 35%) increased risk of progression. The oldest patients experienced 42% (95% CI, 31% to 54%) increased risk of death and 15% (95% CI, 7% to 24%) increased risk of progression or death. This relationship was more pronounced in the first year of follow-up. Age remained marginally significant for OS (P = .08) when adjusted for PS, sex, and presence of liver, lung, or peritoneal metastases, and age was significant in an adjusted model for PFS (P = .005). The age effect did not differ by site of metastatic disease, year of enrollment, type of therapy received, or biomarker mutational status.Conclusion: Younger and older age are associated with poorer OS and PFS among treated patients with mCRC. Younger and older patients may represent higher-risk populations, and additional studies are warranted.
AB - Purpose: This study addressed whether age is prognostic for overall survival (OS) or progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC).Patients and Methods: A total of 20,023 patients from 24 first-line clinical trials in the ARCAD (Aide et Recherche en Cancé rologie Digestive) database were analyzed. Primary age effects and interactions with age, sex, performance status (PS), and metastatic site were modeled using Cox proportional hazards stratified by treatment arm within study.Results: Of total patients, 3,051 (15%) were age ≤ 50 years. Age was prognostic for both OS (P < .001) and PFS (P < .001), with U-shaped risk (ie, highest risk was evident in youngest and oldest patients). Relative to patients of middle age, the youngest patients experienced 19% (95% CI, 7% to 33%) increased risk of death and 22% (95% CI, 10% to 35%) increased risk of progression. The oldest patients experienced 42% (95% CI, 31% to 54%) increased risk of death and 15% (95% CI, 7% to 24%) increased risk of progression or death. This relationship was more pronounced in the first year of follow-up. Age remained marginally significant for OS (P = .08) when adjusted for PS, sex, and presence of liver, lung, or peritoneal metastases, and age was significant in an adjusted model for PFS (P = .005). The age effect did not differ by site of metastatic disease, year of enrollment, type of therapy received, or biomarker mutational status.Conclusion: Younger and older age are associated with poorer OS and PFS among treated patients with mCRC. Younger and older patients may represent higher-risk populations, and additional studies are warranted.
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U2 - 10.1200/JCO.2013.54.9329
DO - 10.1200/JCO.2013.54.9329
M3 - Article
C2 - 25002720
AN - SCOPUS:84907211026
SN - 0732-183X
VL - 32
SP - 2975
EP - 2982
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 27
ER -