Locally Advanced Rectal Cancer: Treatment Approach in Elderly Patients
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).
KeywordsElderly Rectal cancer Radiotherapy Chemotherapy Multidisciplinary Treatment Surgery Quality of life Survival
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.
References and Recommended Reading
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