Consideration of therapeutic approach to advanced colorectal cancer in elderly patients

Yasuhiro Inoue, Yuji Toiyama, Koji Tanaka, Yasuhiko Mohri, Masato Kusunoki


Colorectal cancer (CRC) is predominantly a disease of elderly and is a major cause of morbidity and mortality in the elderly population. The increased availability of treatment options for CRC has made it more difficult for clinicians to decide on the optimal therapeutic approach in elderly patients, because of the potential for poorer outcomes due to an increased burden of comorbidities, functional dependency, and limited life expectancy. It is necessary to determine which elderly patients are likely to benefit from active cancer therapy, and the establishment of treatment markers for multimodality approaches is eagerly awaited. Elderly cancer patients are at risk of exposure to various intrinsic inflammatory mediators, such as tumor-generating cytokines and surgery-induced pro-inflammatory cytokines. It is therefore important to understand the immunological changes occurring in the elderly and to adjust treatment strategies accordingly to reduce the morbidity and mortality associated with multimodality therapy for CRC that induce systemic inflammation. Several inflammation-based factors such as the Glasgow Prognostic Score (GPS) may reflect the balance between tumor progression and host-related immunity, especially in elderly CRC patients. Appropriate selection criteria for multimodality therapy in elderly CRC patients may include not only tumor characteristics, but also host- and/or treatment-related factors such as comorbidities or surrogate markers using inflammation-based factors.


Cite this article as: Inoue Y, Toiyama Y, Tanaka K, Mohri Y, Kusunoki M. Consideration of therapeutic approach to advanced colorectal cancer in elderly patients. Int J Cancer Ther Oncol 2014; 2(1):02014.



Colorectal cancer; Multimodality therapy; Systemic inflammatory response; Glasgow Prognostic Score

Full Text:



Colorectal Cancer Collaborative Group. Surgery for colorectal cancer in elderly patients: a systematic review. Lancet 2000; 356:968-74.

Serra-Rexach JA, Jimenez AB, García-Alhambra MA, et al. Differences in the therapeutic approach to colorectal cancer in young and elderly patients. Oncologist 2012; 17:1277-85.

Inoue Y, Toiyama Y, Tanaka K, Mohri Y, Kusunoki M. Outcome of multimodality therapy for elderly colorectal cancer patients. Cancer and Clinical Oncology 2013; 2:70-80.

Proctor MJ, Morrison DS, Talwar D, et al. An inflammation-based prognostic score (mGPS) predicts cancer survival independent of tumour site: a Glasgow Inflammation Outcome Study. Br J Cancer 2011; 104:726-734.

Okugawa Y, Miki C, Toiyama Y, et al. Loss of tumoral expression of soluble IL-6 receptor is associated with disease progression in colorectal cancer. Br J Cancer 2010; 103:787-795.

Inoue Y, Miki C, Kusunoki M. Nutritional status and cytokine-related protein breakdown in elderly patients with gastrointestinal malignancies. J Surg Oncol 2004; 86:91-8.

Inoue Y, Iwata T, Okugawa Y, et al. Prognostic significance of a systemic inflammatory response in patients undergoing multimodality therapy for advanced colorectal cancer. Oncology 2013; 84:100-7.


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.


International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)

© International Journal of Cancer Therapy and Oncology (IJCTO)

To make sure that you can receive messages from us, please add the '' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.


Number of visits since October, 2013