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Updated: Jan 14, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Preoperative Radiotherapy in Elderly Patients With Locally Advanced Rectal Cancer: A Retrospective Cohort Study.

Jacob F Wahba¹, Mohab Husien², Bogdan Paun³

¹Faculty of Health Sciences, Wilfrid Laurier University, Waterloo, CAN.

|October 24, 2025

Summary

Short-course radiotherapy (SCRT) and chemoradiotherapy (CRT) are effective treatments for elderly patients with locally advanced rectal cancer (LARC), offering comparable survival outcomes and low recurrence rates. Both modalities were well-tolerated, with SCRT providing greater flexibility and fewer complications.

Keywords:

geriatric oncology locally advanced rectal cancer neoadjuvant chemoradiotherapy neoadjuvant radiation treatment oncological outcomes rectal cancer short-course radiotherapy survival analysis

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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

Published on: September 27, 2024

Area of Science:

Oncology
Radiation Oncology
Surgical Oncology

Background:

Locally advanced rectal cancer (LARC) poses treatment challenges in elderly patients (≥75 years).
Optimizing treatment strategies for this demographic is crucial for improving outcomes while minimizing toxicity.

Purpose of the Study:

To compare the outcomes of elderly patients with LARC treated with either short-course radiotherapy (SCRT) or chemoradiotherapy (CRT).
To evaluate the safety and efficacy of SCRT versus CRT in this specific patient population.

Main Methods:

Retrospective chart review of 46 patients (≥75 years) with LARC treated between 2017-2020.
Comparison of outcomes between SCRT (25 Gy/5 fractions) and CRT (50.4 Gy/28 fractions with capecitabine), followed by surgery.
Assessment of surgical margins, pathological complete response (pCR), local recurrence, distant metastasis (DM), overall survival (OS), and cancer-specific survival (CSS).

Main Results:

R0 resection rates were high in both groups (86% SCRT, 100% CRT).
No pCR observed; local recurrence was low (5.9% SCRT, 0% CRT).
No statistically significant differences in OS (73.5% SCRT vs. 75% CRT) or CSS (73.5% SCRT vs. 91.7% CRT) at 24 months median follow-up.

Conclusions:

Both SCRT and CRT are well-tolerated and effective for elderly LARC patients, achieving high R0 resection rates and low recurrence.
CRT demonstrated a trend towards better nodal downstaging, while SCRT offered comparable survival with improved treatment flexibility and fewer complications.