Colorectal cancer in the elderly patient: the role of neo-adjuvant therapy

Dodaro, Concetta Anna; Calogero, Armando; Tammaro, Vincenzo; Pellegrino, Tommaso; Lionetti, Ruggero; Campanile, Silvia; Menkulazi, Marsela; Ciccozzi, Massimo; Iannicelli, Anna Maria; Giallauria, Francesco; Sagnelli, Caterina

doi:10.1515/med-2019-0068

Cited by 9 publications

(6 citation statements)

References 42 publications

(47 reference statements)

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“…Correspondingly, the number of older adults who are cancer patients requiring cancer care will only continue to increase [ 2 ]. That said, cancer care in the current era is increasing in complexity, with newer and better treatment options in aspects of care such as surgery, nutritional needs, nonsurgical treatment, wound care, and cancer surveillance [ 3 ]. Despite the amazing speed of technological adoption across different aspects of health care which are purportedly patient-centric (ie, bringing the service to the patients), care for patients with cancer remains very hospital-centric—the number of required visits to the hospital remains considerable for every patient.…”

Section: Introductionmentioning

confidence: 99%

Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review

Pang¹,

Lau²,

Fong³

et al. 2022

J Med Internet Res

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Background Cancer is likely to remain the most prevalent noncommunicable disease in high-income countries with an older population. Interestingly, no review of attitudes toward telemedicine among older adults has been performed. This is likely to be the group most affected by both cancer and the increasing use of technology in health care. Objective We aimed to map research on the acceptance of telemedicine among older adults who are cancer patients. Methods We conducted a scoping review. PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to September 2020. Articles were included if the study population had a mean or median age ≥65 years, with cancer diagnoses and if the study assessed patients’ acceptance of a telemedicine intervention. Quantitative, qualitative, and mixed method studies were included. Results Out of a total of 887 articles that were identified, 19 were included in the review. Interventions were delivered via telephone, videoconference, web portal, mobile app, wearable technology, and text messaging and included teleconsultation, monitoring and follow-up, psychosocial support and nursing care, and prompts. The most often cited facilitating factor was convenience. Other facilitators included an increase in telemedicine care accessibility, previous positive experiences of telemedicine, appropriate technical knowledge and support, decreased cost, physician recommendations, and privacy conferred by the telemedicine intervention. Barriers include a preference for conventional care along with negative perceptions of telemedicine, concerns about technical difficulties, and confidentiality concerns in the adoption of telemedicine. Conclusions None of the studies explored the ability of tailored interventions to address facilitators and barriers of the acceptance of telemedicine in order to increase its adoption by older adults. Facilitators and barriers will likely differ across different cultural contexts and by type of telemedicine; however, this is a gap in current knowledge. In-depth studies are necessary to determine if interventions could potentially address the barriers identified in this review, to increase acceptability.

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Section: Introductionmentioning

confidence: 99%

Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review

Pang¹,

Lau²,

Fong³

et al. 2022

J Med Internet Res

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“…The majority of patients in this study had advanced tumor at preoperative staging (stage II or III), and after MDT evaluation a total of 23 patients (30.2%) underwent neoadjuvant therapy. Dodaro et al reported that better outcomes of neoadjuvant therapy can be achieved when this treatment is associated with a correct surgical technique “total mesorectal excision” (TME) [ 37 ]. Since many trials demonstrated that neoadjuvant therapy is associated with a decrease in local recurrence rates and an increase in the OS in all patients regardless of age [ 38 ], previous studies have examined the relation between elderly patients and local advanced rectal cancer [ 39 , 40 ], a subanalysis focusing in pTNM stage II and III was carried out to comprehend the role of this patients in terms of CSS and CRR at 5 years.…”

Section: Discussionmentioning

confidence: 99%

Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea

Cuellar-Gomez

Rusli

Ocharan-Hernández

et al. 2022

Journal of Oncology

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Introduction and Objectives. Most patients with colorectal cancer are elderly. Literature is scarce on elderly patients submitted to robotic-assisted surgery, despite the feasibility shown in other age groups. The aim of this study was to evaluate the postoperative and survival outcomes of robotic-assisted colorectal cancer surgery in elderly patients. Materials and Methods. Data of all patients ≥75 years who underwent a robotic-assisted curative resection in Korea University Anam Hospital, Seoul, South Korea, between January 2007 and January 2021 were extracted from a prospectively maintained colorectal cancer database. Patients were subdivided into the three groups according to the age: youngest-old (YO: 75–80 years), middle-old (MO: 81–85), and oldest-old (OO: ≥86 years). Intraoperative findings, postoperative, and oncological outcomes were compared between the groups. Results. Seventy-six consecutive patients (female 52.6%) were included; mean age was 80 years (SD 0.33); mean body mass index (BMI), 23.8 20.9 kg/m2 (SD 3.58); mean total operative time, 279 min (SD 80.93); mean blood loss, 186 ml (SD 204.03); mean postoperative length of stay, 14 days (SD 12.03). Major complications were seen in 2.1% of patients. The 30-day mortality rate was 0%. Average number of lymph node harvested was 20.9 (SD 12.33). Postoperative complications were not statistically different between the groups. Mean follow-up time for cancer-specific survival (CSS) was 99.28 months for the YO, 72.11 months for MO, and 31.25 months for OO groups ( p = 0.045). The CSS rates at 5 years were 27.0%, 21.0%, and 0%, respectively. Recurrence risk was 10.50 times higher in the OO group than the others (adjusted HR, 95% CI 1.868–59.047, p = 0.008). In the multivariable analysis, TNM stage was not a risk factor for CSS in all groups. The number of the harvested nodes was a protective factor for recurrence (HR of 0.932, 95% CI 0.875–0.992, p = 0.027) and CSS (HR of 0.928, 95% CI 0.861–0.999, p = 0.047) in elderly patients. Conclusion. Robotic surgery is highly feasible in elderly and very elderly colorectal cancer patients, providing a favorable operative safety profile and an acceptable cancer-specific survival outcome.

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“…Undergoing an organ transplant can save lives, but it can also increase the risk of cancer [ 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. Among patients who have undergone a solid organ transplant, the risk of getting cancer is 50% [ 79 ] ( Table 1 ).…”

Section: Transplantation and Risk Of Cancermentioning

confidence: 99%

Gastroenterological complications in kidney transplant patients

et al. 2020

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Kidney transplantation is the surgical operation by which one of the two original kidneys is replaced with another healthy one donated by a compatible individual. In most cases, donors are recently deceased. There is the possibility of withdrawing a kidney from a consenting living subject. Usually, living donors are direct family members, but they could be volunteers completely unrelated to the recipient. A much-feared complication in case of kidney transplantation is the appearance of infections. These tend to arise due to immune-suppressor drugs administered as anti-rejection therapy. In this review, we describe the gastrointestinal complications that can occur in subjects undergoing renal transplantation associated with secondary pathogenic microorganisms or due to mechanical injury during surgery or to metabolic or organic toxicity correlated to anti-rejection therapy. Some of these complications may compromise the quality of life or pose a significant risk of mortality; fortunately, many of them can be prevented and treated without the stopping the immunosuppression, thus avoiding the patient being exposed to the risk of rejection episodes.

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Colorectal cancer in the elderly patient: the role of neo-adjuvant therapy

Abstract: AbstractBackgroundNeoadjuvant chemoradiotherapy has a significant role in downstaging cancer. It improves the local control of the disease and can make conservative resection of rectal cancer possible.MethodsWe enrolled 114 patients with subperitoneal rectal cancer who … Show more

Cited by 9 publications

References 42 publications

Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review

Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review

Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Korea

Gastroenterological complications in kidney transplant patients

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