Management of rectal cancer in octogenarians in a teaching hospital in the southern part of the Netherlands between 2008-2011

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A.S.J. van Vuuren, F.W.P.J. van den Berkmortel

Voorzitter(s): prof. dr. J.W. de Fijter, LUMC, Leiden & dr. W.G. Meijer, WestFries Gasthuis, Hoorn

Woensdag 22 april 2015

15:00 - 16:00u in Auditorium 1

Categorieën: parallelsessie (case reports/research)

Parallel sessie: Parallelsessie 1: Case reports/research

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Background:
Rectal Cancer (RC) treatment is multidisciplinary, decreasing recurrence rates at cost of toxicity. Evidence from guidelines is based on studies in young fit patients, however most patients are elder and little evidence is available to guide treatment. Risks of complications are increased. The aim of our study is to evaluate the diagnostic process, treatment, adverse events and outcome of octogenarians treated for RC.

Methods:
Octogenarians with RC diagnosed between 2008-2011 were identified by hospital registry. Case records were studied according to a predefined list of parameters.

Results:
61 octogenarians (mean age 82) with RC, mean adjusted Charlson morbidity score 4,3 (range 3-8) were identified. 13% of these patients were not discussed multidisciplinary, an amount decreasing over the years from 21% (2008) to 8%(2011). In 95% of patients staging was properly performed. 25% of patients were not treated according to multidisciplinary treatment plan. In the trimodality group 31% of patients interrupted chemotherapy due to adverse events and hospitalization was almost doubled compared with the bi-modality treatment group ( 50 vs 30%). Of 15 patients with survival data 47% died < 6 months, 77% died

Conclusion:
Most octogenarians were properly staged and discussed multidisciplinary with increasing numbers over years. However 25% of patients were not treated according to treatment plan. Increased toxicity was documented with increasing treatment modalities and life expectancy appeared short. Information regarding clinical condition and patient preference should be weighed multidisciplinary for the best personalized treatment.