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Treatment of rectal cancer in the older population
Affiliations- Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, I Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland
open access
Abstract
The majority of rectal cancer patients are elderly. Biological age, not chronological age alone, is the main risk factor of postoperative morbidity in this group. Therefore, based on the Comprehensive Geriatric Assessment, we can differentiate three groups of patients: fit, pre-frail and frail. In the fit group, a standard multimodal oncologic treatment can be offered. In the pre-frail group, prerehabilitation should be recommended to improved resilience to surgical stress. In frail patients, a tailored approach should be discussed in a geriatric multidisciplinary team meeting. At present, a whole range of multimodal tailored approaches can be offered to rectal cancer patients. In this group, of much more importance is postoperative functional recovery, including both organ-specific outcomes and the ability to regain independence than currently used outcome indicators. Therefore, as important as cancer staging and tumour biology, it is crucial to understand the health status of an older patient with rectal cancer.
Abstract
The majority of rectal cancer patients are elderly. Biological age, not chronological age alone, is the main risk factor of postoperative morbidity in this group. Therefore, based on the Comprehensive Geriatric Assessment, we can differentiate three groups of patients: fit, pre-frail and frail. In the fit group, a standard multimodal oncologic treatment can be offered. In the pre-frail group, prerehabilitation should be recommended to improved resilience to surgical stress. In frail patients, a tailored approach should be discussed in a geriatric multidisciplinary team meeting. At present, a whole range of multimodal tailored approaches can be offered to rectal cancer patients. In this group, of much more importance is postoperative functional recovery, including both organ-specific outcomes and the ability to regain independence than currently used outcome indicators. Therefore, as important as cancer staging and tumour biology, it is crucial to understand the health status of an older patient with rectal cancer.
Keywords
rectal cancer; older patients; frailty; elderly
About this articleTitle
Treatment of rectal cancer in the older population
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
165-168
Published online
2021-06-09
Page views
382
Article views/downloads
419
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2021;71(3):165-168.
Keywords
rectal cancer
older patients
frailty
elderly
Authors
Jakub Kenig
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