Abstract 271P
Background
Rectal cancer (RC) is a common condition in the elderly population, representing a challenge as many of these patients are frail to undergo surgical treatments. There is increasing evidence of non-operative management of rectal tumors, but this age group is underrepresented in clinical trials. Objective: To evaluate clinical and surgical outcomes of treatments in patients over 70 years old with RC.
Methods
Retrospective, analytical study of patients with localized rectal cancer who underwent neoadjuvant therapy at the Italian Hospital of Buenos Aires between January 2007 and 2020.
Results
83 patients were analyzed, 54% (43) were women, median age 76 years IQR 72 - 81. 75% (59) were T3 or T4, 24% (19) N2. 80% underwent neoadjuvant therapy with radiotherapy and capecitabine, and 20% (16) underwent total neoadjuvant therapy (TNT). Treatment compliance was 95%. 11 patients experienced grade 3-4 toxicity. 54% (43) underwent surgery, 46% (36) patients pursued a watch and wait strategy with complete or near-complete clinical response, and 17 experienced local recurrence. Out of 60 operated patients, 15% (9) achieved complete pathological response. TNT strategy had an OR of 4.5 for achieving complete pathological response, 95% CI 1.04 - 19.85; p=0.048. Median follow-up was 44 months. 32 patients died. N2 was associated with lower survival (HR 2.34 95% CI 1.04-5 p=0.039). Complete clinical response was associated with higher survival (HR 0.3 95% CI 0.14-0.67 p=0.003).
Conclusions
A high treatment compliance rate was observed. Neoadjuvant therapy followed by watch and wait strategy was feasible in 46% of patients, avoiding surgery in 61% of them.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.