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J Geriatr Oncol. 2018 Nov;9(6):696-704. doi: 10.1016/j.jgo.2018.08.001. Epub 2018 Aug 24.

Optimal management of localized rectal cancer in older patients.

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Department of Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Centre, Warsaw, Poland.
Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Northwood HA6 2RN, United Kingdom. Electronic address:
Department of Medical Oncology, Bank of Cyprus Oncology Centre, Cyprus.
Catharina Hospital Cancer Center Eindhoven, GROW Scholl of oncology and developmental Biology, University of Maastricht, the Netherlands.


In advising the optimal management for older patients, health care professionals try to balance the risks from frailty, vulnerability, and comorbidity against the patient's ultimate prognosis, potential functional outcomes and quality of life (QOL). At the same time it is important to involve the patient and incorporate their preferences. But how can we present and balance the potential downside of radical radiotherapy and risks of unsalvageable recurrence against the potential risks of postoperative morbidity and mortality associated with radical surgery? There are currently no nationally approved and evidence-based guidelines available to ensure consistency in discussions with older adults or frail and vulnerable patients. In this overview we hope to provide an insightful discussion of the relevant issues and options currently available.


Brachytherapy; Chemoradiation; Non-operative management; Older adults; Radiotherapy; Rectal cancer


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