title: Safety of laparoscopic surgery for colorectal cancer in patients over 80 years old: a propensity score matching study.
abstract: OBJECTIVE
  To establish the safety of laparoscopic-assisted colorectal resection for colorectal cancer in elderly patients aged ≥80 years.
  
  
  METHODS
  Data were obtained from a chart review of patients who underwent colorectal cancer resection between 2009 and 2014 in Kochi Medical School. The effect of patient age on the extent of lymph node dissection and operative safety was assessed by comparing the short-term results of elderly patients with those of younger patients after propensity score matching.
  
  
  RESULTS
  Of a total of 506 patients with colorectal cancer, 398 underwent laparoscopic surgery and 23% of these patients were aged ≥80 years old. The elderly patients tended to have poorer general condition and larger tumors, although no significant differences were found in tumor invasion, lymph node metastasis, or synchronous distant metastasis between the groups. After adjustment for preoperative factors, we noted that the elderly patients tended to undergo less aggressive surgical resection (P = 0.01). Further analysis after including surgical factors for propensity score matching revealed a similar rate of complications in the two groups (24 vs. 25%, respectively; P = 0.85), and similar postoperative death rates and length of postoperative hospital stay.
  
  
  CONCLUSIONS
  The findings of the present study demonstrate that laparoscopic surgery for colorectal cancer should not be avoided based on simply the age of the patient.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Shiga
authors.affiliation: Cancer Treatment Center, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan. hmaeda@kochi-u.ac.jp.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.affiliation: Cancer Treatment Center, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Kazune
authors.initials: K
authors.lastname: Fujisawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yokota
authors.affiliation: Cancer Treatment Center, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D057216:Propensity Score; D018570:Risk Assessment; D012449:Safety; D016896:Treatment Outcome
keywords: Colorectal cancer; Complication; Elderly; Laparoscopic; Octogenarian; Propensity