Technically safety and oncological validity of laparoscopic surgery in elderly patients with colon cancer.

Ken Kojo, MD, Masanori Naito, MD, PhD, Masahiko Watanabe, MD, PhD, Takahiro Yamanashi, MD, PhD, Hirohisa Miura, MD, Atsuko Tsutsui, MD, Naoto Ogura, MD, Keigo Yokoi, MD, Takeo Sato, MD, PhD, Takatoshi Nakamura, MD, PhD. Kitasato University School of Medicine, Department of Surgery

Introduction: At present, the majority of radical resection of colon cancer is performed laparoscopically in high-volume hospitals. However short-term and midterm outcomes of laparoscopic surgery remain unclear in elderly patients (≥70 y) with colon cancer. This study was designed to clarify the technically safety and oncological validity of laparoscopic resection for elderly patients with colon cancer. 

Patients and Methods: The study group was comprised of 269 patients with stage I to III colon cancer treated by laparoscopic surgery from 2007 through 2012 in our hospital. Surgical outcomes and postoperative complications were compared between 121 patients 70 years or older (elderly group) and 148 patients 69 years or younger (younger group). And oncological outcomes were also compared between elderly group and younger group who were matched for pathological tumor-node-metastasis (TMN) stage.

Results: The mean age of patients was 76.0±4.5 years old in elderly group and 58.7±9.0 years old in younger group. There were no significant differences between elderly group and younger group in operation time (210.8min and 204.1min, respectively), intraoperative blood loss (59.6g and 43.5g, respectively) and postoperative hospital stay (11.5 days and 9.1days, respectively). Postoperative complications occurred in 24 patients (19.8%) in elderly group and 23 patients (15.5%) in younger group. The recurrence free survival rate of elderly group and younger group were similar in stage I (97.3% and 96.2%, respectively), stage II (94.1% and 95.1%, respectively), and stage III (68.4% and 70.0%, respectively).

Conclusion: Operative outcomes, postoperative complications and midterm oncologic outcomes were similar in elderly patients and younger patients with colon cancer who underwent laparoscopic colectomy in our hospital. These results demonstrate that laparoscopic resection of colon cancer is warranted in patients 70 years or older.