Does age matter in survival of rectal cancer patients?

Age plays a significant role in preoperative treatment, chemotherapy dose, hospitalization rates, and survival among older adults with rectal cancer, confirms a study.

The investigators retrospectively reviewed patients aged >80 years (group A) who were treated for clinical stages II to III rectal cancer and collected data on demographics, comorbidities, treatment protocols, adverse events, and time of death. They also compared this cohort with a group of patients aged 65 to 75 years (group B).

Of the 88 patients included in the study, 35 were in group A and 53 in group B. The two cohorts were balanced as regards sex, comorbidities, pretreatment albumin, and haemoglobin levels (p>0.05 for all categories). More patients in group A (25 percent) received preoperative treatment as in-patients (p=0.022) and were treated with radiation only (p<0.0001) as the initial treatment approach.

In 82 percent of patients in group A, the initial chemotherapy dose was reduced to 75 percent or less of the calculated dose compared with 7 percent in group B (p<0.001). More patients in group A discontinued chemotherapy than in group B (55 percent vs 31 percent; p=0.07).

Of note, median overall survival was shorter in group A than in group B (33 vs 55 months; p=0.06), as was 5-year overall survival (27 percent vs 60 percent; p=0.004).

“Oncological treatments of older patients have many unresolved questions mainly because these patients were not eligible to be included in most clinical trials,” the investigators noted.