Rectal Cancer Treatment in the Elderly

Orsini, R.G.; Rostoft, Siri; Rutten, H.J.T.

doi:10.1007/978-1-4471-6609-2_25

Cited by 2 publications

(4 citation statements)

References 132 publications

(73 reference statements)

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“…In order to prevent adverse outcomes in older CRC patients it is important to recognize frailty to determine the most appropriate therapeutic regimen. It is still a discussion how frailty should be adequately identified in the individual patient, as no specific tool is able to identify all heterogeneous aspects of frailty [8,32]. Montroni et al recommend focusing on main predictors as functional and nutritional status and comorbidities as these are targets for prehabilitation programs [8].…”

Section: Discussionmentioning

confidence: 99%

“…When patients seem to be at risk for frailty it is important to perform a complete geriatric assessment in these patients. The most eligible tool to identify frail from fit patients in the geriatric oncological group appears to be the Comprehensive Geriatric Assessment (CGA) [32]. CGA uses a more multidimensional approach than ASA score does, assessing functional, psychosocial and physical health status, polypharmacy and cognition.…”

Section: Discussionmentioning

confidence: 99%

“…CGA uses a more multidimensional approach than ASA score does, assessing functional, psychosocial and physical health status, polypharmacy and cognition. Although time consuming, CGA has been shown to be a useful predictor for postoperative complications in senior patients [32]. In our institution all patients are seen by the surgeon and anesthesiologist to asses peri-operative risk and to shortly evaluate the four geriatric domains.…”

Section: Discussionmentioning

confidence: 99%

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Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years

Ketelaers

Orsini

Burger

et al. 2019

European Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years

Ketelaers

Orsini

Burger

et al. 2019

European Journal of Surgical Oncology

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“…Major LARS results in poor functional outcomes, reduced quality of life and lower levels of independency. Particularly elderly patients consider these outcomes related to functional complaints, quality of life and the maintenance of independency as one of the most important outcomes of a treatment strategy ( 3 , 35 , 36 ). Another aspects that should be considered in particularly in the elderly when the benefits and risk of either a restorative or non-restorative procedure are weighed, is the risk for anastomotic leakage.…”

Section: Discussionmentioning

confidence: 99%

Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly

et al. 2022

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BackgroundThe Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery is unclear. We aimed to describe the prevalence of LARS complaints and the impact on quality of life in the elderly after colorectal cancer surgery.Materials and MethodsPatients were included from seven Dutch hospitals if they were at least one year after they underwent colorectal cancer surgery between 2008 and 2015. Functional bowel complaints were assessed by the LARS score. Quality of life was assessed by the EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires. Outcomes in patients ≥70 years were compared to a reference group of patients <70 years.ResultsIn total 440 rectal cancer and 1183 colon cancer patients were eligible for analyses, of whom 133 (30.2%) rectal and 536 (45.3%) colon cancer patients were ≥70 years. Major LARS was reported by 40.6% of rectal cancer and 22.2% of colon cancer patients ≥70 years. In comparison, patients <70 years reported major LARS in 57.3% after rectal cancer surgery (p=0.001) and in 20.4% after colon cancer surgery (p=0.41). Age ≥70 years was independently associated with reduced rates of major LARS after rectal cancer surgery (OR 0.63, p=0.04). Patients with major LARS reported significantly impaired quality of life on almost all domains.ConclusionElderly should not be withheld a restorative colorectal cancer resection based on age alone. However, a substantial part of the elderly colorectal cancer patients develops major LARS after surgery, which often severely impairs quality of life. Since elderly frequently consider quality of life and functional outcomes as one of the most important outcomes after treatment, major LARS and its impact on quality of life should be incorporated in the decision-making process.

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Rectal Cancer Treatment in the Elderly

Cited by 2 publications

References 132 publications

Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years

Significant improvement in postoperative and 1-year mortality after colorectal cancer surgery in recent years

Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly

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