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Ann Surg Oncol. 2015;22(6):2040-50. doi: 10.1245/s10434-014-4172-x. Epub 2014 Oct 21.

Laparoscopic versus open surgery for colorectal cancer in elderly patients: a multicenter matched case-control study.

Author information

1
Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan, thinoi@hiroshima-u.ac.jp.

Abstract

BACKGROUND:

The safety of laparoscopic surgery (LAP) in elderly patients with colorectal cancer has not been demonstrated. The aim of this study was to compare the outcomes of LAP and open surgery (OP) and estimate the feasibility of LAP in colorectal cancer patients aged ≥ 80 years.

METHODS:

We conducted a propensity scoring matched case-control study of colon and rectal cancer patients aged ≥ 80 years using data from 41 hospitals between 2003 and 2007. A total of 1,526 colon cancer patients and 282 rectal cancer patients underwent surgery and were included in the analysis. The primary end point was 3-year overall survival (OS). Secondary end points included disease-free survival (DFS), cancer-specific survival (CSS), and postoperative complications.

RESULTS:

LAP and OP were compared in 804 colon cancer patients (402 pairs) and 114 rectal cancer patients (57 pairs) after all covariates were balanced, and no significant differences were observed, except for tumor size in colon cancer. OS, DFS, and CSS did not differ between the groups for either colon cancer (P = 0.916, 0.968, and 0.799, respectively) or rectal cancer (P = 0.765, 0.519, and 0.950, respectively). In colon cancer cases, LAP was associated with fewer morbidities than was OP (24.9 vs. 36.3 %, P < 0.001); no such difference was observed for rectal cancer patients (47.4 vs. 40.4 %, P = 0.450).

CONCLUSIONS:

LAP is an acceptable alternative to OP in elderly patients with colorectal cancer.

PMID:
25331007
DOI:
10.1245/s10434-014-4172-x
[Indexed for MEDLINE]

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