Impact of age and comorbidities on the treatment of gastrointestinal malignancies

Abstract

Gastrointestinal malignancies are generally considered diseases that affect older patients, with a peak in incidence in the sixth and seventh decades. Age has often been a surrogate to screen patients who may have more difficulty in tolerating treatment and the related side effects; however, chronologic age does not necessarily correlate with physiological organ impairment or poor performance status, both of which can vary substantially between individuals. Therefore, the assessment of candidacy for the ability to tolerate optimal cancer treatment should focus on the assessment of the extent of comorbidity and functional status. The review aims at providing a broad overview of the published literature regarding the tolerability and efficacy of standard treatment approaches for the most common gastrointestinal malignancies, including esophageal, pancreatic, and colorectal cancer, among elderly patients.