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Short-term and long-term outcomes after laparoscopic surgery for elderly patients with colorectal cancer aged over 80 years: a propensity score matching analysis

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Abstract

Purpose

There has been an increase in the percentage of elderly patients with colorectal cancer (CRC). However, few studies have reported the short- and long-term outcomes of laparoscopic surgery for elderly patients with CRC aged over 80 years.

Methods

This study included 529 patients who underwent laparoscopic resection for clinical stage 0–III CRC at Kobe University Hospital between January 2010 and December 2018. Propensity score matching (PSM) was used to create balanced cohorts of the elderly (aged ≥ 80, n = 113) and the non-elderly (aged < 80, n = 113). Their clinical outcomes were compared after PSM.

Results

After matching, carcinoembryonic antigen (CEA) level was higher in the non-elderly group, and adjuvant chemotherapy was less frequently employed in the elderly group. D3 dissection was performed more frequently and the number of the harvested lymph nodes tended to be larger in the non-elderly group. There was no significant difference in the rates of postoperative complications, reoperation within 30 days, and 30-day mortality between the groups. The 5-year relapse-free survival rate was not statistically different between the two groups (77.3% for the non-elderly vs. 62.7% for the elderly, p = 0.13). The multivariate analyses for the whole cohort showed that the factors of sex, tumor location, operation time, and conversion to open surgery, but not the age, were significant predictors of postoperative complications.

Conclusion

Laparoscopic surgery for colorectal cancer patients aged over 80 years is technically and oncologically safe.

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Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Masako Utsumi, Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Kyosuke Agawa, Naoki Urakawa, Shingo Kanaji, Taro Oshikiri, Tetsu Nakamura & Yoshihiro Kakeji

  2. Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-chou, Chuo-ku, Kobe, 650-0017, Japan

    Takeru Matsuda

Authors
  1. Masako Utsumi
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  2. Takeru Matsuda
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  3. Kimihiro Yamashita
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  4. Hiroshi Hasegawa
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  5. Kyosuke Agawa
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  6. Naoki Urakawa
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  10. Yoshihiro Kakeji
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Corresponding author

Correspondence to Takeru Matsuda.

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Utsumi, M., Matsuda, T., Yamashita, K. et al. Short-term and long-term outcomes after laparoscopic surgery for elderly patients with colorectal cancer aged over 80 years: a propensity score matching analysis. Int J Colorectal Dis 36, 2519–2528 (2021). https://doi.org/10.1007/s00384-021-03973-z

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  • DOI: https://doi.org/10.1007/s00384-021-03973-z

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