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Short- and mid-term outcomes of laparoscopic colorectal surgery in patients  ≥ 85 years old: a multicenter study using a propensity score-matched analysis

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Abstract

Purpose

The number of laparoscopic surgeries for colorectal cancer (CRC) in elderly patients has been increasing. We examined the short- and mid-term outcomes of laparoscopic surgery for CRC in oldest-old patients (≥ 85 years old) compared with the outcomes in younger patients (< 85 years old).

Methods

We retrospectively reviewed primary tumor resection for CRC from April 2015 to December 2020 at six hospitals. Short- and mid-term outcomes were compared after propensity score matching.

Results

From the 1374 patients, 126 matched pairs were selected. In the matched cohort, the duration of postoperative hospital stay was longer in the oldest-old patients than in the younger patients (15 days vs. 12 days, p = 0.001). There were no significant differences between the groups in the rate of Clavien–Dindo grade ≥ 2 postoperative complications (21.4% vs. 15.1%, p = 0.254). The oldest-old patients showed a poorer overall survival (OS) than the younger patients (3-year OS, 79.9% vs. 93.5%, p = 0.005) but comparable recurrence-free survival (RFS) (3-year RFS, 72.2% vs. 81.6%, p = 0.530) and cancer-specific survival rates (CSS) (3-year CSS, 90.1% vs. 99.0%, p = 0.124).

Conclusion

Laparoscopic surgery for CRC in oldest-old patients was performed safely with comparable short-term outcomes to those in younger patients. Although the OS was poorer in the oldest-old patients than in the younger patients, the oncological mid-term outcomes were comparable. Laparoscopic surgery for CRC can be considered acceptable as a treatment in oldest-old patients.

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Acknowledgements

The authors would like to thank FORTE (https://www.forte-science.co.jp/) for the English language review.

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Author notes

  1. Shintaro Hashimoto and Tetsuro Tominaga have contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, National Hospital Organization Ureshino Medical Center, Ureshino, Saga, Japan

    Shintaro Hashimoto, Kazuo To & Hideo Wada

  2. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Shintaro Hashimoto, Tetsuro Tominaga, Takashi Nonaka, Terumitsu Sawai & Takeshi Nagayasu

  3. Department of Surgery, National Hospital Organization Nagasaki Medical Center, Ohmura, Nagasaki, Japan

    Hiroaki Takeshita

  4. Department of Surgery, Isahaya General Hospital, Isahaya, Nagasaki, Japan

    Hidetoshi Fukuoka

  5. Department of Surgery, Sasebo City General Hospital, Sasebo, Nagasaki, Japan

    Masato Araki

  6. Department of Surgery, Saiseikai Nagasaki Hospital, Nagasaki, Nagasaki, Japan

    Kenji Tanaka

Authors
  1. Shintaro Hashimoto
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  2. Tetsuro Tominaga
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  3. Takashi Nonaka
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  4. Kazuo To
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  5. Hideo Wada
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  7. Hidetoshi Fukuoka
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  8. Masato Araki
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  9. Kenji Tanaka
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  10. Terumitsu Sawai
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  11. Takeshi Nagayasu
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Corresponding author

Correspondence to Tetsuro Tominaga.

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Conflict of interest

The authors declare no conflicts of interest. None of the authors has financial interests related to this study to disclose.

Ethical approval

All procedures performed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Hashimoto, S., Tominaga, T., Nonaka, T. et al. Short- and mid-term outcomes of laparoscopic colorectal surgery in patients  ≥ 85 years old: a multicenter study using a propensity score-matched analysis. Surg Today 52, 1292–1298 (2022). https://doi.org/10.1007/s00595-022-02468-w

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  • DOI: https://doi.org/10.1007/s00595-022-02468-w

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