Chemotherapy for elderly Stage II colorectal cancer patients with primary cardiovascular diseases: less is more?

Abstract Objective It is a controversial topic in clinical work to develop an appropriate chemotherapy scheme for elderly stage II colorectal cancer (CRC). We attempted to explore the impact of primary hypertension (HTN) and cardiovascular diseases (CVD) on the prognosis of stage II CRC patients. Methods The data on 2461 stage II CRC patients who received surgical treatment in Shanghai Cancer Center of Fudan University from 2008 to 2018 were retrospectively analyzed. The patients were stratified according to whether they were over 65 years old, and the prognosis difference between HTN/CVD (-) group and HTN/CVD (+) group was compared. Results Among patients over 65 years old with chemotherapy, the overall survival of HTN/CVD (-) group was significantly better than that of HTN/CVD (+) group [HR = 3.118(1.275, 7.625), p = 0.0127], while the overall survival of the two groups were similar in patients with no chemotherapy (p>0.05). No matter whether the age was over 65 years old or not, primary diseases had no effect on disease-free survival (p > 0.05). Conclusion The elderly stage II CRC patients with basic diseases might have poor prognosis due to the cardiovascular events induced by chemotherapy. When making chemotherapy decisions for such patients, clinical workers should pay attention to the close monitoring of cardiovascular events. Weakened chemotherapy regimen may be better.