Multidisciplinary management is strongly suggested in elderly patients with rectal carcinoma

The increasing number of elderly people in the world’s population has led to a parallel increase in the number of older cancer patients, with over 45% of all neoplasia in Europe occurring in patients older than 70 years. Rectal cancer is predominantly a disease of the elderly. Data emerging from cohort and retrospective studies show that elderly patients are less often treated with a multidisciplinary approach, including surgery, radiotherapy and chemotherapy, compared with their younger counterpart, probably based on the impression that older patients show poor tolerance and benefit less from the treatment. Any available analysis has confirmed this concern. Unfortunately, data from studies properly designed for the elderly are currently limited. This article focuses on the state-of-the-art approach in rectal cancer treatment and its role in older patients, focusing on how elderly differ from younger patients in terms of clinical presentation, access to multimodality programs, tolerance of the therapy and outcome.