At the time of diagnosis, approximately a third of patients with rectal cancer present with advanced disease.
Dr Helgi Kjartan Sigurdsson and colleagues from Norway evaluated a group of patients with primary advanced rectal cancer considered as not operable.
The team addressed various clinical aspects relevant for decision-making in a group of patients in need of palliative care.
|Radiotherapy increased survival by a median of 10 months|
|Diseases of the Colon & Rectum|
The investigators assessed 4831 consecutive patients with rectal cancer, registered in the Norwegian rectal cancer registry between 1997 and 2001.
The researchers identified 386 patients without surgical interventions.
The researchers found that patients not surgically treated were significantly older compared with other treatment groups.
Median survival time was 5 months, regardless of age, gender, or hospital category.
The team noted that patients who received radiotherapy had an increased survival, with a median survival time of 10 months.
The median survival time in patients who did not receive radiotherapy was 3 months.
The research team noted that the use of chemotherapy was not associated with improved survival.
Using multivariate analysis, the team observed that only stage of disease and radiotherapy were independent predictors of better survival.
Dr Sigurdsson's team concluded, “Higher age and comorbidity seem to influence choice of treatment in this subgroup of patients with advanced rectal cancer disease.”
“In nonsurgically treated patients, radiotherapy was associated with an improved survival.”
“Our prospective, population-based cohort study emphasizes the dismal prognosis of these patients, which also should challenge our efforts and clinical approaches in palliative care.”