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Evaluation of short- and long-term outcomes following laparoscopic surgery for colorectal cancer in elderly patients aged over 80 years old: a propensity score-matched analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

It remains controversial whether the advantages of laparoscopic surgery for colorectal cancer (CRC) are beneficial in elderly patients (EP, age ≥ 80 years). The present study aimed to evaluate whether age itself is an independent risk factor for laparoscopic surgery by comparing short- and long-term outcomes between non-EP and EP groups.

Methods

We retrospectively analyzed 730 consecutive patients with stage I–III CRC who had undergone elective surgery between 2010 and 2017, using propensity score–matched analysis.

Results

Median follow-up was 49 months. After matching, we enrolled 228 patients. In the matched cohort, estimated operative time, estimated blood loss, lymph node dissection ≥ D3, number of lymph nodes harvested < 12, conversion rate, multivisceral resection rate, postoperative complication rate, and length of postsurgical stay were similar between the two groups. Before matching, compared with the non-EP group, the EP group had significantly shorter overall survival (OS) (p < 0.01), cancer-specific survival (CSS) (p < 0.01), recurrence-free survival (RFS) (p < 0.01), and higher frequency of local recurrence (LR) (p = 0.01); however, there was no significant difference in terms of incidence of LR or CSS between the two groups in the matched cohort. Prior to matching, multivariate analysis identified age ≥ 80 years as an independent prognostic factor for OS (p < 0.01), CSS (p < 0.01), and RFS (p = 0.01); however, after matching, age ≥ 80 years was not an independent poor prognostic factor for OS or CCS.

Conclusions

Laparoscopic surgery offers a safe, effective option for CRC in EP aged ≥ 80 years.

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Authors and Affiliations

  1. Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-kitaku, Sakai, Osaka, 591-8025, Japan

    Toshinori Sueda, Mitsuyoshi Tei, Kentaro Nishida, Yukihiro Yoshikawa, Tae Matsumura, Chikato Koga, Masaki Wakasugi, Hiromichi Miyagaki, Ryohei Kawabata, Masanori Tsujie & Junichi Hasegawa

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  1. Toshinori Sueda
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Correspondence to Toshinori Sueda.

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Ethical approval and informed consent

The Institutional Review Board of Osaka Rosai Hospital approved by the study (approval number 2020-35). This study was eligible for exemption of informed consent. No animal experiments were performed in this study.

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Sueda, T., Tei, M., Nishida, K. et al. Evaluation of short- and long-term outcomes following laparoscopic surgery for colorectal cancer in elderly patients aged over 80 years old: a propensity score-matched analysis. Int J Colorectal Dis 36, 365–375 (2021). https://doi.org/10.1007/s00384-020-03770-0

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