• Yvette H M Claassen, Nina C A Vermeer, Lene H Iversen, Elizabeth van Eycken, Marianne G Guren, Pawel Mroczkowski, Anna Martling, Antonio Codina Cazador, Robert Johansson, Tamara Vandendael, Arne Wibe, Bjorn Moller, Hans Lippert, RuttenHarm J THJTDepartment of Surgery, Catharina Hospital, Eindhoven, The Netherlands.GROW: School of Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands., PortieljeJohanneke E AJEADepartment of Gerontology & Geriatrics, Leiden University Medical Center, Leiden, The Netherlands., Gerrit J Liefers, Fabian A Holman, van de VeldeCornelis J HCJHDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands., and Esther Bastiaannet.
• Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
• Br. J. Cancer. 2018 Aug 1; 119 (4): 517-522.

BackgroundThe optimal treatment strategy for older rectal cancer patients remains unclear. The current study aimed to compare treatment and survival of rectal cancer patients aged 80+.MethodsPatients of ≥80 years diagnosed with rectal cancer between 2001 and 2010 were included. Population-based cohorts from Belgium (BE), Denmark (DK), the Netherlands (NL), Norway (NO) and Sweden (SE) were compared side by side for neighbouring countries on treatment strategy and 5-year relative survival (RS), adjusted for sex and age. Analyses were performed separately for stage I-III patients and stage IV patients.ResultsOverall, 19 634 rectal cancer patients were included. For stage I-III patients, 5-year RS varied from 61.7% in BE to 72.3% in SE. Proportion of preoperative radiotherapy ranged between 7.9% in NO and 28.9% in SE. For stage IV patients, 5-year RS differed from 2.8% in NL to 5.6% in BE. Rate of patients undergoing surgery varied from 22.2% in DK to 40.8% in NO.ConclusionsSubstantial variation was observed in the 5-year relative survival between European countries for rectal cancer patients aged 80+, next to a wide variation in treatment, especially in the use of preoperative radiotherapy in stage I-III patients and in the rate of patients undergoing surgery in stage IV patients.

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