Abstract
839 Background: Rectal cancer (RC) treatment involves multiple modalities with tolerability a concern for some older patients (pts). However, fit older pts have outcomes similar to those of younger pts. We examined the treatment of RC in older pts compared to younger counterparts. Methods: Pts diagnosed with early stage and locally advanced RC from January 2014 to January 2016 were identified from a prospectively maintained electronic database. Characteristics were ascertained through retrospective analysis of pt records. Associations between categorical variables was tested using chi- square. Results: 116 pts diagnosed with RC were identified. Median age was 67 (range 36- 95). 47 (41%) were ≥ 70 years old. Stage distribution is summarised in the Table. Eight pts with stage I disease had rectal polyp cancers, fully resected at endoscopy. 108 were discussed at multidisciplinary meeting (MDM). Treatment (tx) recommendations based on clinical stage and ultimate tx received are outlined in the Table. Clinical Stage and MDM Outcomes Older pts were less likely to receive recommended NACRT than those < 70 (52% and 85% respectively). All pts ≥ 70 who received NACRT completed a full course successfully. Older pts were less likely to proceed to curative resection than younger pts (76% and 94% respectively). Average length of hospital stay was longer in pts ≥ 70: 22.9 vs. 16.6 days in pts < 70. Hospital readmission within 30 days in ≥ 70 vs. < 70 was 9% and 3% respectively. There was no statistical difference in the likelihood of receiving AC based on age. 25% of older pts required dose reductions of AC; 38% did not complete the planned number of cycles. Conclusions: While most older pts tolerated NACRT without significant toxicity, post- operative recovery and tolerability of AC varies widely. Comprehensive geriatric assessment may be useful in guiding tx decisions, and ensuring best outcomes, in this heterogeneous group.[Table: see text]
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