In a nutshell
This study evaluated the short- and long-term outcomes of laparoscopic surgery (LS; keyhole surgery) for the treatment of elderly patients with colorectal cancer (CRC) aged over 80 years. The data showed that LS is a good and safe option for these patients.
Some background
Colorectal cancer (CRC) is one of the most common types of cancer worldwide. The standard treatment for CRC is open surgery or LS. Conventional (open) surgery can be very invasive and is commonly associated with complications. LS consists of the insertion of a thin tube with a camera through a body opening. This tube, which is guided by the doctor, is used to remove the tumor. LS is less invasive and is associated with fewer complications after surgery.
There has been an increase in the percentage of elderly patients with CRC. Elderly patients over 80 years may have severe complications after surgery. However, very few studies have reported the short- and long-term outcomes of LS for the treatment of patients aged 80 or older with CRC.
Methods & findings
This study involved 226 patients who underwent LS for CRC. Patients were divided into 2 groups of patients with similar characteristics. Group 1 included 113 patients who were aged 80 years or older. Group 2 included 113 patients who were aged below 80 years. The average follow-up time was 46 months.
The level of carcinoembryonic antigen (CEA; a protein found in high levels in CRC) was significantly higher in group 2. Chemotherapy after surgery was less frequently used in group 1. The surgical removal of the main lymph nodes was performed more often in group 2. The number of the harvested lymph nodes was also larger in group 2.
The 5-year survival rate without relapse was 77.3% for group 2 compared to 62.7% for group 1. This difference was not statistically significant.
The average length of hospital stay after surgery was longer for group 1 (16 days) than that of group 2 (14 days). There was no significant difference in the rates of complications after surgery and the need of a second surgery within 30 days between the 2 groups.
The bottom line
This study concluded that LS for patients aged 80 years or more with CRC is a good and safe treatment option.
The fine print
The sample size was very small. This study was conducted at a single institution in Japan.
Published By :
International Journal of Colorectal Disease
Date :
Jul 12, 2021