The Role of Frailty in the Treatment of Locally Advanced Rectal Cancer.

Simple Summary: As the population ages, the prevalence of frailty syndrome increases, particularly among elderly patients with rectal cancer. Frail patients are more vulnerable to stressors and may struggle with the standard treatment for locally advanced rectal cancer, which typically includes chemoradiotherapy, surgery, and chemotherapy. While this approach shows good clinical results, it may not be suitable for all frail patients due to potential side effects. Since frail patients are underrepresented in clinical trials, this article highlights the need for new treatment strategies for them. Routine screening for frailty in hospitalized patients is recommended, and treatment should be planned by a multidisciplinary team, including specialists such as geriatricians and oncologists. Adapting guidelines and treatment plans for frail patients is crucial for improving outcomes in this growing population. Owing to the gradual aging of today's population, an increase in the prevalence of frailty syndrome has been noticed. This complex state of health, characterized by decreased resilience and tolerance with concurrent increased vulnerability to stressors and adverse health-related factors, has drawn researchers' attention in recent years. Rectal cancer, which constitutes ~30% of all colorectal cancers, is a disease noticeably related to the elderly. In its locally advanced form, it is conventionally treated with trimodal therapy—neoadjuvant chemoradiotherapy followed by total mesorectal excision and adjuvant chemotherapy. Despite its good clinical outcomes and improvement in rectal cancer local control, as evidenced by clinical trials, it remains unclear if all frail patients benefit from that approach since it may be associated with adverse side effects that cannot be handled by them. As old patients, and frail ones even more noticeably, are poorly represented in the clinical trials describing outcomes of the standard treatment, this article aims to review the current knowledge on the trimodal therapy of rectal cancer with an emphasis on novel approaches to rectal cancer that can be implemented for frail patients. [ABSTRACT FROM AUTHOR]