Real-World Long-Term Outcomes of Operated and Non-Operated Rectal Cancer in the Elderly: A 14-Year Retrospective Multicentre Study

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dc.contributor.authorDemir, Harun
dc.contributor.authorKanyilmaz, Guel
dc.contributor.authorBabalioglu, Ibrahim
dc.contributor.authorDogan, Bedriye
dc.contributor.authorAktan, Meryem
dc.contributor.authorYavuz, Berrin Benli
dc.contributor.authorSafi, Ayse Sumeyye
dc.date.accessioned2026-04-04T13:33:23Z
dc.date.available2026-04-04T13:33:23Z
dc.date.issued2025
dc.departmentİnönü Üniversitesi
dc.description.abstractObjective: Surgical resection is the cornerstone of rectal cancer treatment. Following neoadjuvant chemoradiotherapy (nCRT), many patients undergo surgery. Another group of patients may not undergo surgery for various reasons, regardless of nCRT response. This study investigates the differences in clinical characteristics and long-term oncological outcomes of operated and non-operated elderly rectal cancer patients. Methods: This multicentre observational retrospective cohort analysis included 296 elderly patients (169 surgery, 127 non-surgical) treated at three tertiary cancer centres in Turkey between January 2010 and April 2024. Clinicopathologic features and survival outcomes were compared between groups. Results: Patients in the surgery group were younger (p < 0.000) and had better performance scores (p < 0.000). There were no differences in initial clinical (c) T stages or cM stages; however, cN2 patients were more prevalent in the surgical group and cN1 patients were more prevalent in the non-surgical group (p = 0.010). No differences in radiotherapy treatment schedules were observed among the groups. The surgical group received more concurrent (p = 0.046) and adjuvant (p < 0.000) chemotherapy. Patient refusal (63.8%) was the most common reason among non-surgical patients. The surgery group showed better overall survival (OS) (median, 99 vs. 33 months) (p < 0.000), local recurrence-free survival (LRFS) (97.8% vs. 65.8% at 3 years, p < 0.000), and distant metastasis-free survival (DMFS) (80.3% vs. 73.3% at 3 years, p = 0.022). Conclusion: This study shows that elderly rectal cancer patients without surgery had poor survival and tumour control. Surgical resection in rectal cancer is very important and should be strongly recommended for all medically suitable elderly patients.
dc.identifier.doi10.1111/1754-9485.13872
dc.identifier.endpage592
dc.identifier.issn1754-9477
dc.identifier.issn1754-9485
dc.identifier.issue5
dc.identifier.orcid0000-0001-8579-9939
dc.identifier.orcid0000-0003-2333-353X
dc.identifier.pmid40490671
dc.identifier.scopus2-s2.0-105007761624
dc.identifier.scopusqualityQ2
dc.identifier.startpage586
dc.identifier.urihttps://doi.org/10.1111/1754-9485.13872
dc.identifier.urihttps://hdl.handle.net/11616/109115
dc.identifier.volume69
dc.identifier.wosWOS:001506033900001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofJournal of Medical Imaging and Radiation Oncology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectelderly
dc.subjectnon-surgery
dc.subjectrectal cancer
dc.subjectsurgery
dc.titleReal-World Long-Term Outcomes of Operated and Non-Operated Rectal Cancer in the Elderly: A 14-Year Retrospective Multicentre Study
dc.typeArticle

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