Predictors of curative-intent oncologic management among patients with stage IV rectal cancer

Background: Management of stage IV rectal adenocarcinoma is categorized into curative and palliativeintent strategies. The aim of this study is to determine the incidence of and associations with curativeintent treatment in stage IV rectal cancer. Methods: The National Cancer Database from 2010 to 2016 was queried for patients with stage IV rectal adenocarcinoma and were grouped into curative-intent and non-curative management. Multivariable logistic regression was used to predict use of curative-intent management. Results: 16,862 patients were included in this study: 4886 (30.0%) curative-intent and 11,975 (71.0%) non-curative. Multivariable regression demonstrated curative intent was associated with young age, female gender, white race, private insurance, mucinous histology and anaplastic grade. Conclusion: Use of curative intent oncologic management among patients with stage IV rectal adenocarcinoma is influenced by age, tumor biology and location of metastatic disease. Association with gender and insurance imply the presence of disparity in the delivery of cancer care among this patient population.