Short- and mid-term outcomes of laparoscopic colorectal surgery in patients ≥ 85years old: a multicenter study using a propensity score-matched analysis.

Abstract

The number of laparoscopic surgeries for colorectal cancer (CRC) in elderly patients has been increasing. We examined the short- and mid-term outcomes of laparoscopic surgery for CRC in oldest-old patients (≥ 85years old) compared with the outcomes in younger patients (< 85years old). We retrospectively reviewed primary tumor resection for CRC from April 2015 to December 2020 at six hospitals. Short- and mid-term outcomes were compared after propensity score matching. From the 1374 patients, 126 matched pairs were selected. In the matched cohort, the duration of postoperative hospital stay was longer in the oldest-old patients than in the younger patients (15days vs. 12days, p = 0.001). There were no significant differences between the groups in the rate of Clavien-Dindo grade ≥ 2 postoperative complications (21.4% vs. 15.1%, p = 0.254). The oldest-old patients showed a poorer overall survival (OS) than the younger patients (3-year OS, 79.9% vs. 93.5%, p = 0.005) but comparable recurrence-free survival (RFS) (3-year RFS, 72.2% vs. 81.6%, p = 0.530) and cancer-specific survival rates (CSS) (3-year CSS, 90.1% vs. 99.0%, p = 0.124). Laparoscopic surgery for CRC in oldest-old patients was performed safely with comparable short-term outcomes to those in younger patients. Although the OS was poorer in the oldest-old patients than in the younger patients, the oncological mid-term outcomes were comparable. Laparoscopic surgery for CRC can be considered acceptable as a treatment in oldest-old patients.