How would you approach adjuvant therapy for low-risk stage III colon cancer (T2N1) in an elderly patient with a good PS?

Patients with stage III colon cancer should receive adjuvant therapy to reduce recurrence risk. FOLFOX adjuvant treatment should reduce relative recurrence risk by about 1/3 (e.g from 35% to 25%). Based on the IDEA collaboration, 3 months of treatment is approximately equal to 6 months of adjuvant therapy for N1 disease, particularly using CapeOX.

In this case I would not make a decision based on the patient’s chronologic age, but their functional age. This week I saw a 71 year old that was as healthy as a 50 year old. If a patient in their 70s has no intercurrent medical illness and has normal physiologic and functional status, I would treat them just as a younger person. I am more wary of using capecitabine in older patients however, du...