title: Minimally invasive surgery for colorectal cancer: quality of life and satisfaction with care in elderly patients.
abstract: BACKGROUND
  The purpose of this multicentric prospective study was to evaluate postoperative HRQL and satisfaction with care after laparoscopic colonic resection for colorectal cancer in elderly patients.
  
  
  METHODS
  A total of 116 patients were enrolled in this study: 33 patients older than age 70 years had laparoscopic colectomy, whereas 24 had open colectomy; 44 patients younger than age 70 years had laparoscopic colectomy and 15 of them had open colectomy. The patients answered to three questionnaires about generic (EORTC QLQ C30) and disease-specific quality of life (EORTC CR29) and about treatment satisfaction (EORTC IN-PATSAT32). Nonparametric tests and forward stepwise multiple regression analysis were used for statistical analysis.
  
  
  RESULTS
  One month after surgery, global quality of life (QL2 item) was significantly impaired in elderly patients who had laparoscopic colectomy compared with younger patients who had the same operation (p = 0.003). Similarly, role function (RF), physical function (PF), emotional function (EF), cognitive function (CF), and social function (SF) were impaired in elderly patients who had laparoscopic colectomy compared with younger patients (p < 0.001, p < 0.001, p = 0.013, p < 0.001, p = 0.01, respectively). Fatigue (FA), sleep disturbances (SL), appetite loss (AP), and dyspnea (DY) affected the quality of life of these patients more than younger patients (p < 0.001, p = 0.055, p = 0.051, and p = 0.003, respectively).
  
  
  CONCLUSIONS
  Elderly patients undergoing laparoscopic colectomy for cancer experience less postoperative local complications than elderly patients undergoing open colectomy. Nevertheless, in the first postoperative month, these patients experience a worse global quality of life than younger patients undergoing the same operation with impairment of all the functions and the presence of fatigue, sleep disturbances, appetite loss, and dyspnea.
authors.affiliation: Surgical Oncology Unit, Veneto Institute of Oncology (IOV-IRCCS), Via Gattamelata 64 2, 35128 Padua, PD, Italy. marcoscarpa73@yahoo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Scarpa
authors.forename: Loretta
authors.initials: L
authors.lastname: Di Cristofaro
authors.forename: Matteo
authors.initials: M
authors.lastname: Cortinovis
authors.forename: Eleonora
authors.initials: E
authors.lastname: Pinto
authors.forename: Maurizio
authors.initials: M
authors.lastname: Massa
authors.forename: Rita
authors.initials: R
authors.lastname: Alfieri
authors.forename: Matteo
authors.initials: M
authors.lastname: Cagol
authors.forename: Luca
authors.initials: L
authors.lastname: Saadeh
authors.forename: Aurelio
authors.initials: A
authors.lastname: Costa
authors.forename: Carlo
authors.initials: C
authors.lastname: Castoro
authors.forename: Nicolò
authors.initials: N
authors.lastname: Bassi
authors.forename: Cesare
authors.initials: C
authors.lastname: Ruffolo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome