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Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function

Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function
Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function
The aim of the study was to investigate the role of age and multidimensional functional status in treatment decisions in older patients with colorectal cancer. Three hundred and thirty-seven patients aged 58–95 years with adenocarcinoma of the colon or rectum were interviewed before and after treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), a self-reported severity of morbidity scale, and the Rotterdam Symptom Checklist (RSCL). The OMFAQ rates five dimensions of function: social resources, economic resources, mental and physical health and self-care capacity. The likelihood of patients with Duke's C colorectal cancer receiving adjuvant chemotherapy decreased significantly with age (P = 0.001, trend). Differences in treatment received were not explained by differences in morbidity, economic, mental or physical function, self-care capacity, or any of the RSCL measures. After controlling for age, Duke's C patients who received adjuvant chemotherapy were less impaired in social resources than Duke's C patients who did not (P = 0.06). No other significant pre-treatment differences in functional status were found. Differences in age and social resources exist between patients who do and do not receive adjuvant chemotherapy. Care should be taken to ensure that patients are not excluded from treatment with known survival benefits because of their age, and the question of providing appropriate social support during adjuvant chemotherapy should be re-examined.
elderly, colorectal cancer, treatment decisions, adjuvant chemotherapy, social support
0961-5423
257-262
Bailey, C.
af803055-3a2d-42cf-813c-47558ca0a3e5
Corner, J.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Addington-Hall, J.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Kumar, D.
cce9f133-04b4-48b0-9174-fa6cfca3ce33
Nelson, M.
0b476e33-2b02-4529-b7b4-e87c290bc2fe
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe
Bailey, C.
af803055-3a2d-42cf-813c-47558ca0a3e5
Corner, J.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Addington-Hall, J.
87560cc4-7562-4f9b-b908-81f3b603fdd8
Kumar, D.
cce9f133-04b4-48b0-9174-fa6cfca3ce33
Nelson, M.
0b476e33-2b02-4529-b7b4-e87c290bc2fe
Haviland, J.S.
569aa43b-15bd-4e9d-b4a5-e68a84334cfe

Bailey, C., Corner, J., Addington-Hall, J., Kumar, D., Nelson, M. and Haviland, J.S. (2003) Treatment decisions in older patients with colorectal cancer: the role of age and multidimensional function. European Journal of Cancer Care, 12 (3), 257-262. (doi:10.1046/j.1365-2354.2003.00409.x). (PMID:12919305)

Record type: Article

Abstract

The aim of the study was to investigate the role of age and multidimensional functional status in treatment decisions in older patients with colorectal cancer. Three hundred and thirty-seven patients aged 58–95 years with adenocarcinoma of the colon or rectum were interviewed before and after treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), a self-reported severity of morbidity scale, and the Rotterdam Symptom Checklist (RSCL). The OMFAQ rates five dimensions of function: social resources, economic resources, mental and physical health and self-care capacity. The likelihood of patients with Duke's C colorectal cancer receiving adjuvant chemotherapy decreased significantly with age (P = 0.001, trend). Differences in treatment received were not explained by differences in morbidity, economic, mental or physical function, self-care capacity, or any of the RSCL measures. After controlling for age, Duke's C patients who received adjuvant chemotherapy were less impaired in social resources than Duke's C patients who did not (P = 0.06). No other significant pre-treatment differences in functional status were found. Differences in age and social resources exist between patients who do and do not receive adjuvant chemotherapy. Care should be taken to ensure that patients are not excluded from treatment with known survival benefits because of their age, and the question of providing appropriate social support during adjuvant chemotherapy should be re-examined.

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More information

Published date: 2003
Keywords: elderly, colorectal cancer, treatment decisions, adjuvant chemotherapy, social support
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 365423
URI: http://eprints.soton.ac.uk/id/eprint/365423
ISSN: 0961-5423
PURE UUID: 4c1d80b9-92cf-42d6-8211-592bb63e259c
ORCID for C. Bailey: ORCID iD orcid.org/0000-0002-7528-6264

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Date deposited: 04 Jun 2014 15:39
Last modified: 22 Jul 2022 18:59

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Contributors

Author: C. Bailey ORCID iD
Author: J. Corner
Author: D. Kumar
Author: M. Nelson
Author: J.S. Haviland

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