Optimal oncologic treatment of rectal cancer in patients over 75 years old: Results of a strategy based on oncogeriatric evaluation

Few data are available on the management of elderly rectal cancer patients, and especially on the ability to provide optimal oncological treatment. The aim of this study was to determine the feasibility and results of multimodality treatment for rectal cancer in patients 75years and older after simp...

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Bibliographic Details
Published in:Journal of visceral surgery 2018-02, Vol.155 (1), p.17-25
Main Authors: Suhool, A, Moszkowicz, D, Cudennec, T, Vychnevskaia, K, Malafosse, R, Beauchet, A, Julié, C, Peschaud, F
Format: Article
Language:English
Subjects:
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Aged
Aged, 80 and over
Anal Canal - pathology
Anal Canal - surgery
Chi-Square Distribution
Cohort Studies
Colectomy - methods
Colostomy - methods
Combined Modality Therapy
Disease-Free Survival
Female
Geriatric Assessment - methods
Humans
Male
Neoadjuvant Therapy - methods
Organ Sparing Treatments - methods
Postoperative Complications - mortality
Postoperative Complications - physiopathology
Prognosis
Rectal Neoplasms - mortality
Rectal Neoplasms - pathology
Rectal Neoplasms - therapy
Retrospective Studies
Risk Assessment
Survival Analysis
Treatment Outcome
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Summary:Few data are available on the management of elderly rectal cancer patients, and especially on the ability to provide optimal oncological treatment. The aim of this study was to determine the feasibility and results of multimodality treatment for rectal cancer in patients 75years and older after simplified comprehensive geriatric assessment (CGA) according to Balducci score. We reviewed the charts of elderly patients who underwent surgery for localized middle or low rectal cancer. Patients were classified into three CGA groups depending on their functional reserve, comorbidities, geriatric syndromes, and life expectancy. Neoadjuvant therapy was discussed for 27 patients (47%), but only 56% of them were treated, including 8, 7, and 1 patient from CGA groups 1, 2, and 3, respectively. Fifty-three patients (93%) underwent sphincter-preserving surgical resection and four patients underwent abdominoperineal resection (7%). Postoperative complications were observed in 21 patients (37%). The postoperative complication rate was correlated non-significantly with age (
ISSN:1878-7886
1878-7886
DOI:10.1016/j.jviscsurg.2017.06.005