Stage II-III colorectal cancer in geriatric patients: Clinicopathological features and chemotherapy utilization

Aim: This study aims to assess the clinicopathological characteristics, treatment patterns, and survival outcomes of geriatric patients with stage II-III colorectal cancer. Material and Methods: This retrospective study included 99 geriatric patients (aged ≥65 years) diagnosed with stage II-III colorectal cancer at a single center from 2020 to 2024. Clinical and pathological characteristics, treatment approaches, and survival outcomes were assessed. Results: The median age at diagnosis was 73 years, and 63.6% of patients were male. Adjuvant chemotherapy was administered to 86.9% of patients, with a significantly higher rate in stage III cases compared to stage II (91.3% vs. 58.5%, p < 0.001). Capecitabine-based therapy was the most frequently used chemotherapy regimen. Surgical resection achieved negative margins in 97.9% of cases, with right hemicolectomy being the most frequently performed procedure (54.5%). The median recurrence-free survival (RFS) was 20 months, and recurrence or metastasis occurred in 20.2% of patients, with the liver being the most frequent metastatic site. Treatment-related toxicity was observed in 53.5% of patients, leading to chemotherapy discontinuation in six cases. Conclusion: Adjuvant chemotherapy was more frequently administered in stage III patients, in line with current treatment guidelines. Differences in chemotherapy regimens between stage II and III patients underscore the importance of personalized treatment strategies in the geriatric population. Further research is required to optimize treatment decisions and improve clinical outcomes in this vulnerable group. Keywords: colon cancer, colorectal cancer, geriatrics, adjuvant chemotherapy