Tumor localization and other factors affecting prognosis in elderly patients with colon cancer

Aim: In this study, we aimed to evaluate tumor localization, clinicopathological features, and response to treatment in elderly patients with colon cancer and determine their prognostic significance and effect on overall survival (OS).Material and Methods: Data were retrospectively collected by screening the files of 84 elderly (>75 years old) patients with colon cancer followed up in our hospital between 2010 and 2022. According to tumor localization, the cases were divided into the right colon and left colon cancer groups. The patients' demographic data (age, gender), clinicopathological features, tumor type, grade, size, and localization, and the presence of metastases were evaluated. The presence of K-RAS and BRAF, tumor stage, histology, tumor localization, and whether chemotherapy was applied were evaluated using multivariate and univariate analyses to determine their relationship with OS and prognosis.Results: The study included a total of 84 patients, of whom 42 (50%) were male and 42 (50%) were female. The tumor was located in the right colon in 28 (33.3%) patients and in the left colon in 56 (66.7%) patients. The median mean age was 81 (77-91) years. Thirty-two (38.1%) patients were found to have the K-RAS mutant type, and 52 (61.9%) patients had the K-RAS wild-type. Five (6%) patients had the BRAF mutant type. OS and prognosis were worse in right colon tumors, in patients with RAS mutants, in those not receiving chemotherapy, and in those with advanced-stage tumors. Discussion: Among the elderly patients with colon cancer, tumor localization in the right colon, the presence of RAS mutants, not having received chemotherapy, and the presence of advanced tumors were evaluated as poor prognostic factors. In the geriatric population, patient-tailored treatment should be planned with a multidisciplinary approach by considering the individual requirement of each patient.