title: [Management and clinical outcome in patients over 80 years with rectal cancer treated between 2006 and 2008 in Southern France (PACA region)].
abstract: OBJECTIVE
  Rectal cancer is increasingly prevalent in elderly patients. Their clinical history and outcome after treatment are poorly described. This retrospective study was undertaken to provide more data and to compare therapeutic strategies to the standard of care for younger patients.
  
  
  METHODS
  Patients concerned were aged 80 years or older, with a rectal cancer diagnosed between 2006 and 2008 and treated in Provence-Alpes-Côte-d'Azur (PACA), irrespective of stage and treatment of the disease. Overall survival and relapse-free-survival were correlated with patients' characteristics and treatment. The adopted therapeutic strategy was then compared to the standard-of-care for younger patients.
  
  
  RESULTS
  With a median follow-up of 36 months, among the 160 patients included, the 3-year overall survival and relapse-free survival were 59.2% and 76.6%, respectively for the 117 patients who received a treatment with curative intent. In the multivariate analysis, node status and surgery independently influenced overall survival, while relapse-free survival was influenced by age, N status, and gender. For T0-T2 tumours, patients were treated similarly to younger patients with an overall survival of 83.6% and a relapse-free survival of 95.2%. For T3-T4 tumours, the 3-year relapse-free survival was 65%, even with a less aggressive strategy.
  
  
  CONCLUSIONS
  Surgical resection after evaluation using the Comprehensive Geriatric Assessment (CGA) test should be the standard treatment for localized rectal cancer (T0-T2) in elderly patients, as it is in younger patients. For locally advanced lesions (T3-T4), results obtained after a conservative approach suggest that a non-surgical strategy can be used in elderly patients.
authors.affiliation: Département de radiothérapie, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France. Electronic address: moureaul@ipc.unicancer.fr.
authors.forename: L
authors.initials: L
authors.lastname: Moureau-Zabotto
authors.affiliation: Département de biostatistiques, centre Antoine-Lacassagne, 133, avenue de Valombrose, 06189 Nice, France.
authors.forename: J
authors.initials: J
authors.lastname: Gal
authors.affiliation: Département de radiothérapie, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France; Centre de radiothérapie Saint-Louis, Croix-Rouge française, rue André-Blondel, 83100 Toulon, France.
authors.forename: M
authors.initials: M
authors.lastname: Resbeut
authors.affiliation: Service d'oncologie-radiothérapie, institut Sainte-Catherine, 250, chemin de Baigne-Pieds, CS 800005, 84918 Avignon cedex 9, France.
authors.forename: L
authors.initials: L
authors.lastname: Mineur
authors.affiliation: Centre azuréen de cancérologie, 1, place Docteur-Jean-Luc-Broquerie, 06250 Mougins, France.
authors.forename: É
authors.initials: É
authors.lastname: Teissier
authors.affiliation: Service de gastro-entérologie, centre hospitalier universitaire de Nice, 151, route Saint-Antoine-de-Ginestière, 06202 Nice, France.
authors.forename: X
authors.initials: X
authors.lastname: Hébuterne
authors.affiliation: Centre de radiothérapie du Pays-d'Aix, avenue Henri-Pontier, 13100 Aix-en Provence, France.
authors.forename: P
authors.initials: P
authors.lastname: Muyldermans
authors.affiliation: Département d'oncologie médicale, centre Antoine-Lacassagne, 133, avenue de Valombrose, 06189 Nice, France.
authors.forename: É
authors.initials: É
authors.lastname: Francois
authors.affiliation: Centre de radiothérapie Saint-Louis, Croix-Rouge française, rue André-Blondel, 83100 Toulon, France.
authors.forename: E
authors.initials: E
authors.lastname: Chamorey
authors.affiliation: Département de radiothérapie, centre Antoine-Lacassagne, 133, avenue de Valombrose, 06189 Nice, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Gérard
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D012004:Rectal Neoplasms / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Adenocarcinoma; Adénocarcinome rectal; Elderly patient; Personne âgée; Rectum; Traitement; Treatment