P-0277 - Management of rectal cancer in elderly patients: the experience of a single institution in morocco
|Date||28 June 2014|
|Event||World GI 2014|
|Topics|| Geriatric Oncology
|Citation||Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165|
Although the median age of patients diagnosed with rectal cancer is above 70 years, little is known about specific characteristics and management in the elderly. The aim of this study was to define characteristics of rectal cancer in elderly patients and compare the therapeutic results with the younger patients.
105 patients treated for rectal cancer between April 2007 and December 2012 at the department of medical oncology of Fez Morocco were retrospectively reviewed. Patient, tumor and treatment variables were compared between the elderly (70 years or older), and the younger patients.
Elderly patients represented 32.4% (n = 34) of all patients treated for rectal cancer during the same period. They were more likely to be males (73.5% versus 51.6%). At the time of diagnosis, metastatic tumors were more frequent in elderly patients (50% versus 31%). The performance status was ≥ 2 on the ECOG scale in 26.5% of cases in the elderly versus 34%. Tumors in lower third of rectum were less common among elderly patients (46% vs 64,6%). Fewer elderly patients had symptomatic tumor (11.7% versus 29%). When adjusted for stage, elderly patients less frequently received preoperative chemoradiotherapy (15% versus 28%), radical curative procedure (21% versus 35%), adjuvant or palliative polychemotherapy (63% versus 78%). Elderly patients have less recurrences than younger patients with a longer period: a recurrence rate of 13% with an average of 28 months in the elderly, against a rate of 56% and an average of 20.6 months in younger patients. With a mean follow up of 27 months, progression free survival was 9 months in elderly versus 8.3 in younger patients, and disease free survival was 17 months in elderly versus 19 months.
Rectal cancer in patients 70 years and older is relatively rare in our region and less aggressive. Age by itself seems to influence their therapeutic management. A lot of studies are still needed to standardize and improve treatment of elderly patients with rectal cancers.