A review on surgery as treatment for elderly patients with rectal cancer

This review summarizes the outcomes of surgical treatment for rectal cancer in elderly patients.

The risk of developing rectal cancer increases with age. Up to half of the patients with rectal cancer are 75 or older. However, elderly patients also have other health problems, thus they are exposed to a higher risk of developing complications to treatments such as surgery or chemotherapy, which could potentially cure the cancer. Therefore, these patients are more likely to undergo safer, but non-curative treatments. There are no standard practices of care for elderly patients. The current review evaluated previous research on surgical treatment for rectal cancer in elderly patients.

This review included 48 studies that evaluated surgical outcomes for patients over 70 years of age diagnosed with rectal cancer. The main parameters evaluated were types of surgery used, complications after surgery, other treatment types, survival rates and quality of life after treatment. Overall, there were no significant differences regarding surgical outcomes in elderly patients compared to younger patients. Complications following surgery were similar across age groups (of approximately 40%), although the severity of the complications was higher in elderly patients. Quality of life was also similar irrespective of age. Although overall survival (defined as the percentage of patients who survived for a certain period of time) was lower in elderly patients, probably because they often have additional health problems, the cancer-specific survival (defined as the percentage of patients who have not died because of rectal cancer for a defined period of time) was comparable to that of younger patients. 

In summary, this review showed that elderly patients with rectal cancer treated with surgery had similar outcomes compared to younger patients, suggesting that age should not be a determining factor in the choice of treatments for the elderly. However, other health problems of the patient should be taken into consideration when deciding treatment.