title: Laparoscopic surgery for patients with colorectal cancer produces better short-term outcomes with similar survival outcomes in elderly patients compared to open surgery.
abstract: The number of operations on elderly colorectal cancer (CRC) patients has increased with the aging of the population. The aim of this study was to evaluate surgical outcomes in elderly patients who underwent laparoscopic or open surgery for CRC. We analyzed the data of 280 patients aged 80 or over who underwent surgery for CRC between January 2001 and December 2010. Seventy-one pairs were selected after propensity score matching for laparoscopic or open surgery. Operative time, return to normal bowel function, length of hospital stay, postoperative complications, overall survival (OS), recurrence-free survival (RFS), and prognostic factors affecting survival were investigated. In matched cohorts, operative time in the laparoscopic group was longer than in the open group (P < 0.001). In the laparoscopic group, time to flatus passage (P < 0.001) and length of postoperative hospital stay (P = 0.037) were shorter than in the open group. The rate of operation-related morbidity was higher in the open group (P = 0.019). There was no difference in OS and RFS between two groups. This study suggests that laparoscopic surgery for CRC in elderly patients may be safe and feasible, with better short-term outcomes. OS and RFS, however, were not different in both groups.
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Soo Yun
authors.initials: SY
authors.lastname: Moon
authors.affiliation: Biometric Research Branch, Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, Korea.
authors.forename: Eon Chul
authors.initials: EC
authors.lastname: Han
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kang
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, Korea.|Cancer Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.|Colorectal Cancer Center, Seoul National University Cancer Hospital, Seoul, Korea.
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Colorectal cancer; elderly patients; laparoscopic surgery; surgical outcomes