title: Comparative outcomes of rectal cancer surgery between elderly and non-elderly patients: a systematic review.
abstract: Elderly people represent almost all patients diagnosed with and treated for rectal cancer, and this trend is likely to become more apparent in the future. Surgical management and treatment decisions for this disease are becoming increasingly complex, but only a few reports deal specifically with older patients. In this systematic review, we provide an overview of published studies of outcomes after curative surgery for rectal cancer in elderly people (>70 years). We identified 48 studies providing information about postoperative results, survival, surgical approach, stoma formation, functional results, and quality of life after rectal resection for cancer. We found that advanced chronological age should not, by itself, exclude patients from curative rectal surgery or from other surgical options that are available for younger patients. Although overall survival is lower in elderly patients than in younger patients, cancer-specific survival does not decrease with age. However, the level of evidence for most studies was weak, emphasising the need for high-quality clinical trials for this population.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Pierre and Marie Curie University, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Manceau
authors.forename: Mehdi
authors.initials: M
authors.lastname: Karoui
authors.forename: Andrew
authors.initials: A
authors.lastname: Werner
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Mortensen
authors.forename: Laurent
authors.initials: L
authors.lastname: Hannoun
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome