title: Age impacts the pattern of care for elderly patients with rectal cancer.
abstract: OBJECTIVE
  This study analyzed the current approaches for rectal cancer treatment in elderly patients.
  
  
  METHODS
  We retrospectively studied 240 rectal cancer patients who had undergone radiotherapy from 2000 to 2008. The ages of the patients ranged from 65 and 75 years (group A, n = 127) and older than 75 years (group B, n = 113). The distribution of the Charlson comorbidity index was similar between the two groups, but the ECOG performance status (PS) differed between the groups (66 % of the patients of group A were PS 0, and 40 % were PS 0 in group B (p < 0.0001)). The tumor stages were comparable between groups.
  
  
  RESULTS
  The median age of the patients was 74.3 years (range 65-90.6). Treatment was discussed during a multidisciplinary cancer team meeting before treatment for 55 % of the cases in group A and 73 % of the cases in group B (p < 0.001), and treatment proposals were in accordance with guidelines in 96 % of the cases in group A and 76 % of the cases in group B (p < 0.001). Group B patients received slightly less concurrent chemotherapy (35 vs. 30 % for group A; p = 0.54), more hypofractionated radiotherapy (41 vs. 54 % for group A; p = 0.064), less surgery (92 vs. 80 % for group A; p = 0.014), and less adjuvant chemotherapy (34 vs. 10 % for group A; p < 0.001). Finally, 80 % of the patients in group A and 60 % of the patients in group B received treatment in accordance with guidelines (p = 0.007) and in the logistic regression model. Non-metastatic patients who were aged below 75 years were predicted for conformal management (HR = 0.323; 95 % CI = 0.152-0.684) irrespective of their performance status, comorbidity, or disease stage.
  
  
  CONCLUSIONS
  Treatment proposals and administered therapy differed according to age.
authors.affiliation: Center de lutte contre le cancer Paul Strauss, 3, rue de la porte de l'hôpital, 67065, Strasbourg cedex, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Guillerme
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Clavier
authors.forename: Hélène
authors.initials: H
authors.lastname: Nehme-Schuster
authors.forename: Valérie
authors.initials: V
authors.lastname: Leroy
authors.forename: Damien
authors.initials: D
authors.lastname: Heitz
authors.forename: Catherine
authors.initials: C
authors.lastname: Schumacher
authors.forename: Méher Ben
authors.initials: MB
authors.lastname: Abdelghani
authors.forename: Cécile
authors.initials: C
authors.lastname: Brigand
authors.forename: Jean Emmanuel
authors.initials: JE
authors.lastname: Kurtz
authors.forename: Georges
authors.initials: G
authors.lastname: Noël
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D003695:Delivery of Health Care; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy