The following is a summary of “Association of age with outcomes in locally advanced rectal cancer treated with neoadjuvant therapy followed by surgery,” published in the JUNE 2023 issue of Surgery by Sonal, et al.
For a study, researchers examined the correlation between age and outcomes in patients with Locally Advanced Rectal Cancer (LARC) who underwent neoadjuvant therapy followed by major surgery.
A retrospective study was conducted on a cohort of 328 LARC patients, comprising 99 patients younger than 70 years (referred to as the “younger” group) and N = 229 ≥ 70 years (referred to as the “elderly” group). The study period spanned from 2004 to 2018.
Compared to the younger group, elderly patients had higher scores on the American Society of Anesthesiologists (ASA) scale (P < 0.05), indicating a higher level of comorbidities, as well as higher Charlson Comorbidity Index (CCI) scores. The elderly group also had longer hospital stays and a higher rate of 30-day readmissions (P < 0.05). In terms of survival outcomes, elderly patients had worse overall survival (OS) and disease-free survival (DFS) (P < 0.001) but had similar disease-specific survival (DSS) compared to the younger group. Age itself was not found to be associated with the hazard of death (HR 1.01, 95% CI 0.98–1.03). However, factors such as higher Charlson Comorbidity Index (HR 1.29, 95% CI 1.01–1.5), presence of extramural vascular invasion (HR 4.98, 95% CI 2.84–8.74), and receiving adjuvant therapy (HR 0.37, 95% CI 0.21–0.64) were significantly associated with the hazard of death when controlling for stage, tumor distance from the anal verge, and neoadjuvant completion.
The study demonstrated that comorbidities and lower rates of receiving adjuvant therapy, rather than chronological age, were associated with poorer overall survival in elderly patients with LARC who underwent neoadjuvant therapy followed by major surgery. The findings highlighted the importance of managing comorbidities and ensuring appropriate adjuvant therapy to improve outcomes in this patient population.