Preoperative chemoradiotherapy leads to more severe grade 3/4 toxicities ( 25.6 % vs. 15.8 % , p = 0.01 ) and more permanent stomas ( 33.3 % vs. 22.8 % , p = 0.014 ) in elderly patients who were less often operated on than younger patients ( 95.8 % vs. 99.0 % , p = 0.008 ) .