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Locally Advanced Rectal Cancer: Treatment Approach in Elderly Patients

  • Francesca De FeliceEmail author
  • Daniele Crocetti
  • Veronica Maiuri
  • Martina Parisi
  • Francesco Marampon
  • Luciano Izzo
  • Giorgio De Toma
  • Daniela Musio
  • Vincenzo Tombolini
Lower Gastrointestinal Cancers (AB Benson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lower Gastrointestinal Cancers

Abstract

Independently of age, evidence-based guidelines recommend a multidisciplinary treatment approach in patients with locally advanced rectal cancer (LARC). But actually, elderly patients are grossly underrepresented in clinical trials, accounting < 10% of enrolled cases. Therefore, LARC management in elderly patients remains a crucial issue in daily practice, especially due to their frailty. Multiple clinical factors, including general health status, cognitive status, co-morbidity, disability, and life expectancy should be considered to understand the complexities of geriatric assessment and then define therapy. We use a patient-centered approach in order to tailor the optimal treatment strategy. We treat fit elderly patients as younger patients, including neoadjuvant chemoradiotherapy (CRT), surgery, and adjuvant chemotherapy. Whereas, in vulnerable and frail patients, we propose standard CRT (vulnerable patients) or radiotherapy alone (frail patients).

Keywords

Elderly Rectal cancer Radiotherapy Chemotherapy Multidisciplinary Treatment Surgery Quality of life Survival 

Notes

Compliance with Ethical Standards

Conflict of Interest

Francesca De Felice declares that she has no conflict of interest. Daniele Crocetti declares that she has no conflict of interest. Veronica Maiuri declares that she has no conflict of interest. Martina Parisi declares that she has no conflict of interest. Francesco Marampon declares that he has no conflict of interest. Luciano Izzo declares that he has no conflict of interest. Giorgio De Toma declares that he has no conflict of interest. Daniela Musio declares that she has no conflict of interest. Vincenzo Tombolini declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Francesca De Felice
    • 1
    Email author
  • Daniele Crocetti
    • 2
  • Veronica Maiuri
    • 1
  • Martina Parisi
    • 1
  • Francesco Marampon
    • 1
  • Luciano Izzo
    • 2
  • Giorgio De Toma
    • 2
  • Daniela Musio
    • 1
  • Vincenzo Tombolini
    • 1
  1. 1.Department of RadiotherapyPoliclinico Umberto I, “Sapienza” University of RomeRomeItaly
  2. 2.Department of Surgery “Pietro Valdoni”Policlinico Umberto I, “Sapienza” University of RomeRomeItaly

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