Association between age and local recurrence of rectal cancer: results from a retrospective study of 902 patients

Due to the ageing of the general population, there has been a relative increase of elderly patients with rectal cancer. The relation between age and the risk of local recurrence after apparently curative surgery for cancer of rectum and rectosigmoid was studied in a retrospective study of 902 patients, diagnosed from 1984 through 1991 in the southwestern part of the Netherlands. Three age-groups were defined: 15-64 (n = 328), 65-74 (n = 327) and 75 and over (n = 247). After exclusion of postoperative deaths and controlling for unrelated causes of death, 5-year survival rates were similar in the three age-groups (70%, 71% and 75%, respectively). Local recurrence rates, however, decreased with age from 23% to 18% and 14%, respectively. In multivariate analysis, the hazard ratios were 1, 0.84 and 0.66, respectively. These results suggest that local recurrence occurs less frequently in the elderly, which needs confirmation from prospective studies and warrants consideration in decisions about the use of adjuvant treatment.