e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Patterns of care and outcomes of elderly patients with resected stage III colorectal cancer in Australia (#240)

Oliver Piercey 1 , Clara Leung 1 , Margaret Lee 2 3 4 5 , Jeanne Tie 1 3 4 6 , Justin Yeung 3 6 , Jacob McCormick 1 7 , Malcolm Steel 2 , Valerie Heong 4 6 , Peter Gibbs 3 4 6 , Rachel Wong 2 4 5 , Hui Li Wong 1 4
  1. Peter MacCallum Cancer Centre, Kew East, VIC, Australia
  2. Eastern Health, Box Hill, Victoria
  3. Western Health, Melbourne, VIC
  4. Walter and Eliza Hall Institute, Parkville, VIC
  5. Monash University, Melbourne, VIC
  6. University of Melbourne, Melbourne, VIC
  7. Melbourne Health, Parkville, VIC


We aimed to compare patterns of adjuvant chemotherapy (AC) use and cancer-related outcomes between elderly (≥70y) and younger (<70y) patients with resected stage III CRC.


We analysed data from the ACCORD-CRC registry(1), which prospectively collects treatment and outcome data from consecutive patients with CRC treated across seven Melbourne hospitals. Patients who underwent resection for stage III CRC from 2005-2018 were included. Variation in treatment, chemotherapy completion rates and disease-free survival (DFS) were compared between elderly and younger patients.



Data was obtained for 1512 patients; median age was 68y and 685 (45%) were ≥70y. Overall, 59% elderly and 94% younger patients received AC. Compared to younger patients, elderly patients were less likely to be offered AC (72% vs 96%, p<0.0001) and when offered, were more likely to decline treatment (15% vs 2.8%; p <0.0001). The most frequent reasons for not offering elderly patients AC were age plus comorbidities, followed by comorbidities alone and age alone (42%, 29% and 23%, respectively). For those who commenced treatment, elderly patients were less likely to receive oxaliplatin (27% vs 85%, p <0.0001) and to complete planned treatment (76% vs 86%, p <0.0001). After 42m median follow up, 3-year DFS rates were higher for patients who received AC regardless of age: 71% vs 64% in elderly (HR 0.72, p=0.046); 77% vs 40% in younger patients (HR 0.26, p <0.0001). In elderly patients who were offered AC, 3-year DFS was higher in those who accepted treatment compared to those who declined (71% vs 59%, HR 0.61, p=0.03).



Almost one third of elderly patients with stage III CRC in this real-world cohort are not offered AC, with almost a quarter of these patients not being offered due to age alone. When offered AC, elderly patients frequently decline treatment, despite it being associated with improved DFS.

  1. 1. Kosmider S, Jones I, Hibbert M, Hunter A, McLaughlin S, Johns J, et al. Towards establishing a national colorectal cancer database: lessons learnt from Bio21 molecular medicine informatics model. ANZ J Surg. 2008;78(9):803-9