Rectal Cancer Surgery in Nonagenarians: A Multi-Institutional Study of Feasibility and Risk-Stratified Outcomes

Evidence regarding rectal cancer surgery in nonagenarians remains extremely limited because most previous studies combined colon and rectal cancers despite their distinct surgical complexity and functional implications. Rectal surgery in the oldest-old is particularly challenging because pelvic dissection, anastomotic complications, and permanent stoma formation may substantially affect perioperative risk and postoperative quality of life. As population aging progresses, clarifying the feasibility and oncologic validity of rectal cancer surgery in carefully selected nonagenarians has become increasingly important.