Minimally Invasive Compared to Open Colorectal Cancer Resection for Older Adults: A Population-based Analysis of...

Area of Science:

• Geriatric Surgery
• Colorectal Cancer (CRC) Management
• Minimally Invasive Surgery (MIS) Outcomes

Background:

• Limited data exist on long-term functional outcomes for older adults undergoing MIS for CRC.
• Assessing long-term healthcare dependency and time-at-home is crucial for treatment decisions in elderly patients.

Purpose of the Study:

• To compare long-term healthcare dependency and time-at-home between older adults (≥70 years) undergoing MIS versus open resection for CRC.
• To evaluate functional outcomes as patient-centered endpoints in elderly CRC patients.

Main Methods:

• Population-based analysis of patients ≥70 years undergoing CRC resection (2007-2017) using administrative datasets.
• Outcomes included receipt of homecare and "high" time-at-home (≤14 institution-days/year) in the 5 years post-surgery.
• Time-to-event and Cox multivariable models were used to analyze homecare use and time-at-home probability.

Main Results:

• Of 16,479 patients, 47.5% underwent MIS.
• The MIS group showed lower homecare use at 6 months (22.3% vs. 31.6%) and 1 year (14.8% vs. 19.4%) compared to open surgery.
• MIS was associated with a higher probability of high time-at-home at 5 years (54.9% vs. 41.2%).

Conclusions:

• Minimally invasive surgery for CRC resection in older adults is linked to reduced long-term functional dependence.
• MIS is associated with lower homecare needs and increased time-at-home post-surgery.
• These findings highlight MIS as a favorable option for elderly CRC patients, impacting long-term treatment burden and decision-making.