Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620834
Title:
Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer.
Authors:
Montroni, I. [et al]; Daniels, Ian R. ( 0000-0002-9114-0812 )
Abstract:
With an expanding elderly population and median rectal cancer detection age of 70 years, the prevalence of rectal cancer in elderly patients is increasing. Management is based on evidence from younger patients, resulting in substandard treatments and poor outcomes. Modern management of rectal cancer in the elderly demands patient-centered treatment, assessing frailty rather than chronological age. The heterogeneity of this group, combined with the limited available data, impedes drafting evidence-based guidelines. Therefore, a multidisciplinary task force convened experts from the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology and the American College Surgeons Commission on Cancer, with the goal of identifying the best practice to promote personalized rectal cancer care in older patients. A crucial element for personalized care was recognized as the routine screening for frailty and geriatrician involvement and personalized care for frail patients. Careful patient selection and improved surgical and perioperative techniques are responsible for a substantial improvement in rectal cancer outcomes. Therefore, properly selected patients should be considered for surgical resection. Local excision can be utilized when balancing oncologic outcomes, frailty and life expectancy. Watch and wait protocols, in expert hands, are valuable for selected patients and adjuncts can be added to improve complete response rates. Functional recovery and patient-reported outcomes are as important as oncologic-specific outcomes in this age group. The above recommendations and others were made based on the best-available evidence to guide the personalized treatment of elderly patients with rectal cancer.
Citation:
Personalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer. 2018 Eur J Surg Oncol
Publisher:
Elsevier
Journal:
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Issue Date:
15-Aug-2018
URI:
http://hdl.handle.net/11287/620834
DOI:
10.1016/j.ejso.2018.08.003
PubMed ID:
30150158
Additional Links:
https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(18)31272-1
Type:
Journal Article
Language:
en
ISSN:
1532-2157
Appears in Collections:
Colorectal Surgery; HeSRU publications; 2018 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMontroni, I. [et al]en
dc.contributor.authorDaniels, Ian R.en
dc.date.accessioned2018-10-02T13:27:45Z-
dc.date.available2018-10-02T13:27:45Z-
dc.date.issued2018-08-15-
dc.identifier.citationPersonalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer. 2018 Eur J Surg Oncolen
dc.identifier.issn1532-2157-
dc.identifier.pmid30150158-
dc.identifier.doi10.1016/j.ejso.2018.08.003-
dc.identifier.urihttp://hdl.handle.net/11287/620834-
dc.description.abstractWith an expanding elderly population and median rectal cancer detection age of 70 years, the prevalence of rectal cancer in elderly patients is increasing. Management is based on evidence from younger patients, resulting in substandard treatments and poor outcomes. Modern management of rectal cancer in the elderly demands patient-centered treatment, assessing frailty rather than chronological age. The heterogeneity of this group, combined with the limited available data, impedes drafting evidence-based guidelines. Therefore, a multidisciplinary task force convened experts from the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology and the American College Surgeons Commission on Cancer, with the goal of identifying the best practice to promote personalized rectal cancer care in older patients. A crucial element for personalized care was recognized as the routine screening for frailty and geriatrician involvement and personalized care for frail patients. Careful patient selection and improved surgical and perioperative techniques are responsible for a substantial improvement in rectal cancer outcomes. Therefore, properly selected patients should be considered for surgical resection. Local excision can be utilized when balancing oncologic outcomes, frailty and life expectancy. Watch and wait protocols, in expert hands, are valuable for selected patients and adjuncts can be added to improve complete response rates. Functional recovery and patient-reported outcomes are as important as oncologic-specific outcomes in this age group. The above recommendations and others were made based on the best-available evidence to guide the personalized treatment of elderly patients with rectal cancer.en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urlhttps://linkinghub.elsevier.com/retrieve/pii/S0748-7983(18)31272-1en
dc.rightsArchived with thanks to European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncologyen
dc.subjectWessex Classification Subject Headings::Gastroenterologyen
dc.titlePersonalized management of elderly patients with rectal cancer: Expert recommendations of the European Society of Surgical Oncology, European Society of Coloproctology, International Society of Geriatric Oncology, and American College of Surgeons Commission on Cancer.en
dc.typeJournal Articleen
dc.identifier.journalEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncologyen
dc.type.versionIn press (epub ahead of print)en

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