Laparoscopic surgery for colorectal cancer in patients over 80 years of age: the morbidity outcomes

Abstract

PurposeThe aim of this study was to compare the outcomes between patients under 60 years of age and older patients over 80 years of age who underwent laparoscopic colorectal surgery with colorectal cancer.MethodsA retrospective analysis of 519 colorectal patients who underwent laparoscopic colorectal surgery for colorectal adenocarcinoma between January 2007 and December 2012 was collected and categorized into 2 groups of patients, those under 60 years of age (n = 404) and those over 80 years of age (n = 115).ResultsThe group of patients over 80 years of age had a significantly higher ASA physical status classification (P < 0.001), more preoperative comorbidities (P < 0.001), had a tendency towards more tumors in a colonic location (P = 0.034), and more advanced American Joint Committee on Cancer TNM stage (P = 0.001). A higher proportion of right hemicolectomy and abdominoperineal resection was performed and more transfusions were required in the group of patients over 80 years of age (P = 0.002 and P = 0.001, respectively). There were no significant differences in operative time, conversion rate, resection margins, and numbers of harvested lymph nodes, hospital stay, and morbidity between the 2 groups. No postoperative mortality was found in the present study. The 3-year DFS for over 80 years age group and under 60 years age group were 73.5% and 73.9%, respectively (P = 0.770).ConclusionLaparoscopic colorectal surgery was effective and safe for elderly patients over 80 years of age and resulted in postoperative outcomes similar to those in younger patients. The postoperative morbidity after laparoscopic colorectal cancer surgery was not increased in over 80 years of age.

Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience

“…The result was negative, meaning surgeons did not favor either type of operation, based on pre-operatively estimated primary tumor stage. However, they did favor open resection in older patients, which is unfounded since laparoscopy was found to be comparable between older and younger patients in regard to shortand long-term effects [19,20]. Nevertheless, this is a topic that could benefit from further research on a larger sample, in order to determine the true differences between the two surgical approaches on long-term effects.…”

Preoperative radiation as part of a multidisciplinary strategy for a medically inoperable patient with a bleeding colon cancer

“…A large, single-institution study confirmed age as significant predictor of mortality after resection for colon cancer, with an OR of 1.5 for mortality for every 10-year increase in age 5. Laparoscopic resection has shown to be beneficial for older patients with no increase in technical complications6 7 with the same benefit expected for the robotic approach.…”

Effect of Age on Laparoscopic Surgery and Postoperative Chemotherapy in Elderly Patients With Colorectal Cancer

“…Secondly, the long-term outcomes for laparoscopic CRC surgery were not assessed. Previous studies have reported that the long-term outcomes did not differ between younger and elderly patients [ 30 ]. Thirdly, the number of patients that stopped postoperative chemotherapy was relatively small because patients who might have stopped chemotherapy were already excluded during the treatment recommendation process.…”