Propensity Score-Matched Analysis of Minimal Invasive Surgery versus Open Surgery for Colorectal Cancer in Older...

Area of Science:

• Surgical Oncology
• Geriatric Surgery

Background:

• Increasing life expectancy presents challenges in managing elderly patients with colorectal cancer (CRC).
• Optimal surgical management for elderly CRC patients remains debated due to underrepresentation in clinical trials.

Purpose of the Study:

• To evaluate the efficacy and outcomes of minimal invasive surgery (MIS) compared to open surgery (OS) in elderly patients (age ≥ 65) with colorectal adenocarcinoma.

Main Methods:

• Retrospective analysis of 975 elderly patients (age ≥ 65) with colorectal adenocarcinoma from 2012-2015.
• Comparison between 842 patients undergoing OS and 133 patients undergoing MIS.
• Propensity score matching was utilized to minimize patient selection bias.

Main Results:

• After propensity score matching, the MIS group demonstrated a significantly shorter postoperative hospital stay (p = 0.025).
• Chronic lung disease was more prevalent in the OS group (p = 0.039) and associated with higher complication rates (Clavien-Dindo, p = 0.001) and longer hospital stays (p = 0.028).

Conclusions:

• Chronological age alone should not preclude elderly patients from undergoing MIS for colorectal cancer.
• MIS shows comparable postoperative morbidity to OS in the elderly, with the advantage of a reduced hospital stay.