Differential short-term outcomes of laparoscopic resection in colon and rectal cancer patients aged 80 and older: an analysis of Nationwide Inpatient Sample

Surg Endosc. 2021 Feb;35(2):872-883. doi: 10.1007/s00464-020-07459-x. Epub 2020 Feb 18.

Abstract

Background: Approximately, 22.6% of colorectal cancer surgeries were performed on patients aged 80 or over. The present study aimed to evaluate the use of laparoscopic resection and its short-term surgical outcomes in patients who were aged 80 and older and diagnosed with colon cancer or rectal cancer in parallel.

Methods: In this retrospective population-based study, colon and rectal cancer patients ≥ 80 years undergoing laparoscopic resection or open resection were identified from the United States National Inpatient Sample (2005-2014). Primary outcomes were postoperative complication and in-hospital mortality. Logistic regression analyses were performed to assess the short-term effectiveness of laparoscopic and open resection.

Results: In this study, 40,451 colon cancer patients and 1117 rectal cancer patients were included. Multivariate analysis revealed that laparoscopic resection was significantly associated with lower risks for developing postoperative complications (aOR = 0.67; 95%, CI 0.64-0.71) and in-hospital mortality (aOR = 0.37; 95% CI 0.32-0.43) compared to open resection in colon cancer patients. For rectal cancer patients, multivariate analysis indicated that laparoscopic resection was significantly associated with a lower risk of developing postoperative complications (aOR = 0.41; 95% CI 0.32-0.52) but was not associated with in-hospital mortality.

Conclusion: Compared to open resection, laparoscopic resection has better or similar short-term surgical outcomes in colon and rectal cancer patients ≥ 80 years.

Keywords: Colon cancer; Elderly; Laparoscopic resection; Rectal cancer; Surgical outcomes.

MeSH terms

  • Aged, 80 and over
  • Colonic Neoplasms / surgery*
  • Digestive System Surgical Procedures / methods*
  • Digestive System Surgical Procedures / mortality
  • Female
  • Humans
  • Inpatients
  • Laparoscopy / methods*
  • Male
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Treatment Outcome