- •Elderly patients with locally advanced rectal cancer (LARC) have worse OS & DFS.
- •Elderly patients with LARC have similar DSS as younger patients.
- •Comorbidity and adjuvant therapy, and not age, drive OS & DFS.
We aimed to assess the association of age with outcomes in patients with Locally Advanced Rectal Cancer (LARC) who received neoadjuvant therapy followed by major surgery.
Retrospective review of 328 patients with LARC, N = 99 < 70 years (younger) versus N = 229 ≥ 70 years (elderly) from 2004 to 2018.
Elderly patients had a higher American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), length of stay and 30-day readmissions (p < 0.05). They also had worse overall survival (OS) & disease-free survival (DFS) (p < 0.001), but similar disease-specific survival (DSS) compared to younger group. Age was not associated with hazard of death (HR 1.01, 0.98–1.03). Rather, CCI (HR 1.29, 1.01–1.5), extramural vascular invasion (HR 4.98, 2.84–8.74), and adjuvant therapy (0.37, 0.21–0.64) were significantly associated with the hazard of death; when controlled for stage, tumor distance from anal verge, and neoadjuvant completion.
Comorbidities and lower rates of adjuvant therapy, and not chronologic age, are associated with poor OS of elderly patients with LARC treated with neoadjuvant therapy and major surgery.
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Published online: December 13, 2022
Accepted: December 4, 2022
Received in revised form: November 15, 2022
Received: July 20, 2022
Publication stageIn Press Journal Pre-Proof
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