Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study

Abstract

Background Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old. Methods Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups. Results The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p < .01 and 14% vs. 32%, p < .05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p < .01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p < .01), there was no difference in 5-year disease-specific survival between the groups. Conclusion Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

“…The complications were similar between LR and OR in this study, except for less blood loss with LR, supported by the general principle of LR (4-8) and by a previous meta-analysis (53) and a cohort study (54). A recent study showed that LR and OR was safe both in elderly and non-elderly patients (55). This lack of difference in complications might play a role in the lack of difference in survival.…”

Should we resect colorectal cancer in patients over the age of 85?

“…This conclusion is supported by research from Vallribera Valls et al [ 14 ] who demonstrated that laparoscopic approaches in those over 85 are not associated with an increase in morbidity or length of stay. This is also mirrored by more recent studies of Ueda et al [ 15 ] and Hashida et al [ 16 ], both of whom have demonstrated laparoscopic surgery in the elderly population to be feasible, safe and have equitable outcomes to those in younger age brackets.…”

Robotic versus laparoscopic colorectal surgery in elderly patients in terms of recovery time: a monocentric experience

“…Over the years, thanks to improvement of anesthesiology and surgical technologies, indications for major surgery have also been extended to the elderly population [ 19 ]. Several studies describe laparoscopic colorectal surgery in elderly patients as technically and oncologically safe compared to non-elderly, with similar results [ 19 , 26 ]. Frasson et al showed how laparoscopic colorectal resection improved short-term postoperative outcome more in elderly than in younger patients [ 13 ].…”