title: Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients.
abstract: OBJECTIVE
  The aim of this study was to compare the postoperative short- and long-term outcomes after laparoscopic colorectal surgery (LCS) between octogenarians and healthy middle-aged patients.
  
  
  METHODS
  Between January 1997 and July 2009, 655 consecutive laparoscopic surgeries for colorectal cancer patients were operated by 1 colorectal surgeon. Ninety-three patients were octogenarians (≥80 years), and 133 patients were case-matched middle-aged (60-69 years) patients. We analyzed the mean operative time, blood loss, type of surgery for rectal cancer, length of hospital stay, mortality, and morbidity. The overall survival curve was constructed using the Kaplan-Meier method.
  
  
  RESULTS
  The American Society of Anesthesiologists classification was significantly higher in the octogenarians than in the middle-aged controls. However, there were no significant differences between the two groups in terms of the incidence of morbidities (11.7 vs. 9.2 %) and length of hospital stay (12.1 vs. 10.9 days). The number of lymph nodes harvested was significantly fewer (p < 0.05) and the operative time significantly shorter (p < 0.05) in the octogenarians than in the middle-aged controls. At a mean follow-up of 38.2 months, the overall 5-year survival rate was 64.8 % in the octogenarians and 92.4 % in the middle-aged group, whereas the cancer-specific 5-year survival rate was 91 % in the octogenarians and 95.7 % in the middle-aged group.
  
  
  CONCLUSIONS
  We suggest that advanced age should not be a contraindication for LCS, even for complex procedures, such as laparoscopic rectal resection.
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan. kokiotsu@iwate-med.ac.jp.
authors: Koki
authors: K
authors: Otsuka
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Toshimoto
authors: T
authors: Kimura
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Masanori
authors: M
authors: Hakozaki
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Mizunori
authors: M
authors: Yaegashi
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Teppei
authors: T
authors: Matsuo
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Hitoshi
authors: H
authors: Fujii
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Kei
authors: K
authors: Sato
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Tomoki
authors: T
authors: Hatanaka
authors: Department of Surgery, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.
authors: Akira
authors: A
authors: Sasaki
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal cancer; Comparative study; Elderly; Laparoscopy; Octogenarian