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Laparoscopic Surgery Is Acceptable for Elderly Patients With Colorectal Cancer: A Propensity Score-matched Study
Makoto Takahashi1, Kazuhiro Sakamoto2, Takahiro Irie2
1Department of Coloproctological Surgery, Faculty of Medicine, and Medical Technology Innovation Center Clinical Research and Trial Center, Juntendo University, Tokyo, Japan mktakaha@juntendo.ac.jp.
Background/Aim:
The study was performed to examine the suitability of laparoscopic surgery for elderly patients with colorectal cancer.
Patients And Methods:
The subjects were 242 patients aged ≥80 years who underwent primary tumor resection of colorectal cancer using laparoscopic assisted colectomy (LAC, n=145) or open colectomy (OC, n=97). Propensity score matching used to balance the characteristics of the groups resulted in 76 patients being assigned to each group.
Results:
Before matching, Glasgow Prognostic Score (GPS), American Society of Anesthesiologists physical status (ASA-PS), and previous abdominal surgery differed significantly between the groups (p<0.05), but after matching, all covariates were balanced (p≥0.05). Short-term outcomes were better after LAC (p<0.05), including fewer postoperative complications and less delirium. Regarding long-term outcomes, 5-year overall survival did not differ significantly between the groups (p=0.91).
Conclusion:
In elderly patients with colorectal cancer, short-term results are better after LAC than OC and long-term results are similar. These findings indicate that LAC is acceptable in this patient population.
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