Management of rectal cancer in the elderly: the role of local excision.

Abstract

The incidence of rectal cancer increases with age in an ageing population, difficult decisions regarding the management of rectal cancers in frail patients with co-morbidities are becoming increasingly common. Surgery is the mainstay of treatment for rectal cancer, however the standard approach of total mesorectal excision is associated with a risk of operative morbidity and mortality in the elderly patient. Local excision can macroscopically clear cancer with lower operative risk, however it is considered a non-fefinitive resection. Controversy exists in many instances where the balance between operative mortality, local recurrence risk and overall lifespan is debated.