Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004

<p>Abstract</p> <p>Background</p> <p>Limited information is available regarding the effect of age on choice of surgical and oncological treatment for rectal cancer. The objective of this study was to assess the influence of age on treatment and outcome of rectal cancer....

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Main Authors: Johansson Robert, Påhlman Lars, Jung Bärbel, Nilsson Erik
Format: Article
Language:English
Published: BMC 2009-02-01
Series:BMC Cancer
Online Access:http://www.biomedcentral.com/1471-2407/9/68
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author Johansson Robert
Påhlman Lars
Jung Bärbel
Nilsson Erik
author_facet Johansson Robert
Påhlman Lars
Jung Bärbel
Nilsson Erik
author_sort Johansson Robert
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Limited information is available regarding the effect of age on choice of surgical and oncological treatment for rectal cancer. The objective of this study was to assess the influence of age on treatment and outcome of rectal cancer.</p> <p>Methods</p> <p>We utilized data in the Swedish Rectal Cancer Registry (SRCR) from patients treated for rectal cancer in Sweden in 1995–2004.</p> <p>Results</p> <p>A total of 15,104 patients with rectal cancer were identified, 42.4% of whom were 75 years or older. Patients ≥75 years were less likely to have distant metastases than younger patients (14.8% vs. 17.8%, <it>P </it>< 0.001), and underwent abdominal tumor resection less frequently (68.5% vs. 84.4%, <it>P </it>< 0.001). Of 11,725 patients with abdominal tumor resection (anterior resection [AR], abdominoperineal excision [APE], and Hartmann's procedure [HA]), 37.4% were ≥75 years. Curative surgery was registered for 85.0% of patients ≥ 75 years and for 83.9% of patients < 75 years, <it>P </it>= 0.11. Choice of abdominal operation differed significantly between the two age groups for both curative and non-curative surgery, The frequency of APE was similar in both age groups (29.5% vs. 28.6%), but patients ≥75 years were more likely to have HA (16.9% vs. 4.9%) and less likely to have preoperative radiotherapy (34.3vs. 67.2%, <it>P </it>< 0.001). The relative survival rate at five years for all patients treated with curative intent was 73% (70–75%) for patients ≥75 years and 78% (77–79%) for patients < 75 years of age. Local recurrence rate was 9% (8–11%) for older and 8% (7–9%) for younger patients.</p> <p>Conclusion</p> <p>Treatment of rectal cancer is influenced by patient's age. Future studies should include younger and older patients alike to reveal whether or not age-related differences are purposive. Local recurrence following surgery for low tumors and quality of life aspects deserve particular attention.</p>
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spelling doaj.art-2d2b92252c47470c99f0b1087d9e37612022-12-22T03:09:50ZengBMCBMC Cancer1471-24072009-02-01916810.1186/1471-2407-9-68Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004Johansson RobertPåhlman LarsJung BärbelNilsson Erik<p>Abstract</p> <p>Background</p> <p>Limited information is available regarding the effect of age on choice of surgical and oncological treatment for rectal cancer. The objective of this study was to assess the influence of age on treatment and outcome of rectal cancer.</p> <p>Methods</p> <p>We utilized data in the Swedish Rectal Cancer Registry (SRCR) from patients treated for rectal cancer in Sweden in 1995–2004.</p> <p>Results</p> <p>A total of 15,104 patients with rectal cancer were identified, 42.4% of whom were 75 years or older. Patients ≥75 years were less likely to have distant metastases than younger patients (14.8% vs. 17.8%, <it>P </it>< 0.001), and underwent abdominal tumor resection less frequently (68.5% vs. 84.4%, <it>P </it>< 0.001). Of 11,725 patients with abdominal tumor resection (anterior resection [AR], abdominoperineal excision [APE], and Hartmann's procedure [HA]), 37.4% were ≥75 years. Curative surgery was registered for 85.0% of patients ≥ 75 years and for 83.9% of patients < 75 years, <it>P </it>= 0.11. Choice of abdominal operation differed significantly between the two age groups for both curative and non-curative surgery, The frequency of APE was similar in both age groups (29.5% vs. 28.6%), but patients ≥75 years were more likely to have HA (16.9% vs. 4.9%) and less likely to have preoperative radiotherapy (34.3vs. 67.2%, <it>P </it>< 0.001). The relative survival rate at five years for all patients treated with curative intent was 73% (70–75%) for patients ≥75 years and 78% (77–79%) for patients < 75 years of age. Local recurrence rate was 9% (8–11%) for older and 8% (7–9%) for younger patients.</p> <p>Conclusion</p> <p>Treatment of rectal cancer is influenced by patient's age. Future studies should include younger and older patients alike to reveal whether or not age-related differences are purposive. Local recurrence following surgery for low tumors and quality of life aspects deserve particular attention.</p>http://www.biomedcentral.com/1471-2407/9/68
spellingShingle Johansson Robert
Påhlman Lars
Jung Bärbel
Nilsson Erik
Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
BMC Cancer
title Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
title_full Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
title_fullStr Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
title_full_unstemmed Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
title_short Rectal cancer treatment and outcome in the elderly: an audit based on the Swedish rectal cancer registry 1995–2004
title_sort rectal cancer treatment and outcome in the elderly an audit based on the swedish rectal cancer registry 1995 2004
url http://www.biomedcentral.com/1471-2407/9/68
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AT pahlmanlars rectalcancertreatmentandoutcomeintheelderlyanauditbasedontheswedishrectalcancerregistry19952004
AT jungbarbel rectalcancertreatmentandoutcomeintheelderlyanauditbasedontheswedishrectalcancerregistry19952004
AT nilssonerik rectalcancertreatmentandoutcomeintheelderlyanauditbasedontheswedishrectalcancerregistry19952004