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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2015

01-06-2015 | Colorectal Cancer

Laparoscopic Versus Open Surgery for Colorectal Cancer in Elderly Patients: A Multicenter Matched Case–Control Study

Authors: Takao Hinoi, MD, PhD, Yasuo Kawaguchi, MD, Minoru Hattori, PhD, Masazumi Okajima, MD, PhD, Hideki Ohdan, MD, PhD, Seiichiro Yamamoto, MD, PhD, Hirotoshi Hasegawa, MD, PhD, Hisanaga Horie, MD, PhD, Kohei Murata, MD, PhD, Shigeki Yamaguchi, MD, PhD, Kenichi Sugihara, MD, PhD, Masahiko Watanabe, MD, PhD, the Japan Society of Laparoscopic Colorectal Surgery

Published in: Annals of Surgical Oncology | Issue 6/2015

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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.
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Metadata
Title
Laparoscopic Versus Open Surgery for Colorectal Cancer in Elderly Patients: A Multicenter Matched Case–Control Study
Authors
Takao Hinoi, MD, PhD
Yasuo Kawaguchi, MD
Minoru Hattori, PhD
Masazumi Okajima, MD, PhD
Hideki Ohdan, MD, PhD
Seiichiro Yamamoto, MD, PhD
Hirotoshi Hasegawa, MD, PhD
Hisanaga Horie, MD, PhD
Kohei Murata, MD, PhD
Shigeki Yamaguchi, MD, PhD
Kenichi Sugihara, MD, PhD
Masahiko Watanabe, MD, PhD
the Japan Society of Laparoscopic Colorectal Surgery
Publication date
01-06-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4172-x

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