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Ostomy prevalence and survival in elderly patients with stage III and IV rectal cancer
Author(s) -
Badic Bogdan,
Oguer Maude,
Cariou Melanie,
Kermarrec Tiphaine,
Bouzeloc Servane,
Nousbaum JeanBaptiste,
Robaszkiewicz Michel,
Quénéhervé Lucille
Publication year - 2021
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.14225
Subject(s) - medicine , stage (stratigraphy) , stoma (medicine) , colorectal cancer , population , cancer , logistic regression , gastroenterology , surgery , paleontology , environmental health , biology
Aim Oncological strategies in the elderly population are often debated. The objective of this study was to investigate the survival rates and prevalence of ostomy in elderly patients operated on for stage III and IV rectal cancers. Methods This retrospective multicentric population‐based study included 151 patients aged ≥75 years with stage III and IV rectal adenocarcinoma who underwent surgery between 2007 and 2014. Multivariable logistic regression was used to assess the impact of different prognostic factors. Results The median age of the patients was 81 years (range: 75–97 years) with 40 patients >85 years of age. Age was significantly correlated with overall survival (OS) in both stage III and IV cancers ( P < 0.001). For patients ≥80 years the presence of comorbid conditions was associated with a lower chance of survival ( P = 0.02). A digestive stoma was created in 67 (76.1%) patients with stage III cancer and 26 (29.54%) had a stoma reversal. A palliative derivative stoma was performed in half of patients with stage IV cancer. Adjuvant chemotherapy was independently associated with improved 5‐year OS ( P < 0.001). Conclusions Age, comorbidities and adjuvant chemotherapy were independent predictors for OS. Resection of rectal tumors in fit elderly patients should be promoted; however, patients should be aware of the high risk of stoma. Geriatr Gerontol Int 2021; 21: 670–675 .