title: Laparoscopy could be the best approach to treat colorectal cancer in selected patients aged over 80 years: Outcomes from a multicenter study.
abstract: BACKGROUND
  The efficacy and safety of treating elderly patients with colorectal cancer (CRC) is of concern. This study aimed to compare the short- and long-term outcomes of elective laparoscopic vs. open surgery to treat CRC in very elderly patients.
  
  
  METHODS
  All patients aged >80 years and who had undergone a colectomy for CRC without metastasis between July 2005 and April 2012 were considered for inclusion. Demographic, clinical, operative, and postoperative data, plus overall and disease-free survival rates, were retrospectively collected and compared between two groups of patients that underwent an open procedure (OP group) or laparoscopy (LG).
  
  
  RESULTS
  123 patients were enrolled (55 OPG, 68 LG). Median age was similar between the groups (84 vs. 83 years, respectively; NS). Duration of surgery was significantly lower in OPG (170 vs. 200min; p=0.030). Overall mortality at 3 months was 8.3%: it tended to be greater in the OPG (16.5% vs. 1.5%, NS). Morbidity was significantly greater in the OPG compared to the LG (52.7% vs. 27.5%; p=0.021), resulting in significantly longer hospital stay (12 vs. 8 days, respectively; p<0.001). Pathological findings were similar between the two groups. Cumulative overall survival rates at 3 and 5 years were significantly greater after laparoscopy (85% and 72%) compared to open surgery (58.2% and 48%, respectively; p<0.001).
  
  
  CONCLUSIONS
  Our study suggests that laparoscopy is safe and could increase overall survival compared to open surgery in elderly patients suffering from CRC.
  
  
  CONCLUSIONS
  This retrospective study compared the short- and longer-term outcomes of patients aged >80 years and undergoing elective laparoscopic or open surgery for CRC between 2005 and 2012.
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France. Electronic address: leslie.rinaldi@gmail.com.
authors.forename: Leslie
authors.initials: L
authors.lastname: Rinaldi
authors.affiliation: AP-HM, Timone Hospital, Department of Digestive and Visceral Surgery, Marseille, France.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ouaissi
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Barabino
authors.affiliation: Department of Public Health and Biostatistics, Faculty of Medicine, Aix Marseille University, France.
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Léa
authors.initials: L
authors.lastname: Clavel
authors.affiliation: AP-HM, Timone Hospital, Department of Digestive and Visceral Surgery, Marseille, France.
authors.forename: Igor
authors.initials: I
authors.lastname: Sielezneff
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Roblin
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Jack
authors.initials: J
authors.lastname: Porcheron
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Williet
authors.affiliation: Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.affiliation: Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
authors.affiliation: Department of Gastroenterology and Digestive Oncology, University Hospital of St Etienne, University Jean Monnet, LINA EA 4624, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Phelip
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Colorectal cancer; Elderly patients; Laparoscopy