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Attend this session at the
2019 ASCO Annual Meeting!


Session: Symptoms and Survivorship

Type: Poster Session

Time: Monday June 3, 1:15 PM to 4:15 PM

Location: Hall A

Early mortality after resection of locally advanced rectal cancer in elderly United States patients.

Sub-category:
End-of-Life Care

Category:
Symptoms and Survivorship

Meeting:
2019 ASCO Annual Meeting

Abstract No:
11529

Poster Board Number:
Poster Session (Board #221)

Citation:
J Clin Oncol 37, 2019 (suppl; abstr 11529)

Author(s): Helmneh M. Sineshaw, K Robin Yabroff, Vassiliki Liana Tsikitis, Ahmedin Jemal, Timur Mitin; American Cancer Society, Atlanta, GA; Oregon Health and Science University, Portland, OR

Abstract Disclosures

Abstract:

Background: Early mortality after resection of locally advanced rectal cancer in patients age 75 and older has not been studied in the United States. This information could inform clinical decision-making for patients who achieve complete clinical response after neoadjuvant therapy and consider watchful waiting versus surgical resection. Methods: Using the National Cancer Data Base, we identified patients age 75 years and older who underwent surgery for clinical stage II or III rectal cancer between 2004-2015. We performed multivariable logistic regression analyses to assess associations between patient and facility characteristics and 30-day, 90-day, and 6-month mortality. Results: Among 11,326 patients, 94% underwent resection and the remaining 6% underwent local excision. Overall early mortality rates after surgery were 4%, 7.6% and 11% for 30-day, 90-day and six-month, respectably. Six-month mortality varied by age subgroup (8% in 75-79 years old to 17.7% in 85 years and older), and comorbidity score (9.5% for comorbidity score = 0 to 18.5% for comorbidity score ≥ 2). Between 2004 and 2015, six-month mortality declined significantly from 11.9% in 2004-2007 to 9.8% in 2012-2015 (P trend = 0.0029), with the decline larger among patients age 85 years and older (from 19.4% in 2004-2007 to 15.3% in 2012-2015, P trend = 0.0377). In the multivariable analysis, older age, higher comorbidity score, and lower facility case volume were significantly associated with higher odds of six-month mortality. Patients treated at National Cancer Institute (NCI) designated centers had 32% lower odds of six-month mortality compared with those treated at non-NCI designated teaching/research centers. Conclusions: Post-operative six-month mortality among patients age 75 years and older with locally advanced rectal cancer in the US declined steadily over the past decade. Older age, high comorbidity score, and low facility case volume were associated with higher six-month mortality after surgery. Additional efforts are needed to guide elderly patients and their physicians in discussing treatment options for locally advanced rectal cancer.

 
Other Abstracts in this Sub-Category:

 

1. Randomized trial of a hospice video decision aid for patients with advanced cancer and their caregivers.

Meeting: 2019 ASCO Annual Meeting Abstract No: 11513 First Author: Areej El-Jawahri
Category: Symptoms and Survivorship - End-of-Life Care

 

2. Is there a shift in use of subacute rehabilitation (SAR) instead of hospice referral since immunotherapy became available?

Meeting: 2019 ASCO Annual Meeting Abstract No: 11530 First Author: Jonathan Yeh
Category: Symptoms and Survivorship - End-of-Life Care

 

3. End-of-life care and immune checkpoint inhibitors.

Meeting: 2019 ASCO Annual Meeting Abstract No: 11531 First Author: Hazel O'Sullivan
Category: Symptoms and Survivorship - End-of-Life Care

 

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