Purpose: To describe treatment patterns and outcome for short-course preoperative radiotherapy in patients with mobile rectal cancer according to age and comorbidity. Patients and methods: All 914 patients, aged ≥ 50 years, with T2-T3, N0-2, M0 rectal cancer, newly diagnosed in Southern Netherlands between 2002 and 2006 were included. The influence of age, patient and tumour characteristics and type of surgery on treatment with 5 × 5 Gy preoperative radiotherapy and survival was analysed. Results: Patients younger than 70 years received radiotherapy less frequently if they had multiple comorbid conditions (OR = 0.4), a history with previous cancer (OR = 0.2) or had undergone low anterior resection (OR = 0.5). Among patients aged 70 years or older, men received radiotherapy more often than women (OR = 2.0) and withholding radiotherapy was associated with multiple comorbid conditions (OR = 0.3), low anterior resection (OR = 0.3), diabetes mellitus (OR = 0.5) or age above 80 years (OR = 0.5). Among patients ≥ 70 years old, hazard ratios for death were increased for males (HR = 1.5), higher age (HR = 1.06 per year of age), multiple comorbidities (HR = 1.7) and pulmonary disease (HR = 1.6) independently. Receiving radiotherapy had no significant influence on survival after adjustment for other prognostic variables. Conclusions: Withholding short-course preoperative radiotherapy depends on age only in patients aged 70 years or older. As a rule, factors that predict life expectancy, determine also the decision to withheld preoperative radiotherapy. With the exception that women receive radiotherapy less frequently as compared to men, although women survive longer.

Additional Metadata
Keywords Elderly, Population-based, Preoperative radiotherapy, Rectal cancer
Persistent URL dx.doi.org/10.1016/j.eurger.2011.07.007, hdl.handle.net/1765/34615
Citation
Maas, H.A.A.M., Lemmens, V.E.P.P., Cox, S., Martijn, H., Rutten, H.J.T., Coebergh, J.W.W., & Janssen-Heijnen, M.L.G.. (2011). The effects of age and comorbidity on treatment patterns for radiotherapy and survival in patients with mobile rectal cancer: A population-based study. European Geriatric Medicine, 2(5), 273–279. doi:10.1016/j.eurger.2011.07.007