Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Asian J Endosc Surg. 2021 Apr;14(2):200-206. doi: 10.1111/ases.12848. Epub 2020 Aug 16.
The number of elderly patients with colorectal cancer has gradually increased. Laparoscopic colorectal surgery is widely used to approach colorectal cancer. The aim of this study was to evaluate long-term outcomes in octogenarians who underwent laparoscopic colorectal surgery for colorectal cancer.
This study included 158 patients aged 80 or over who underwent surgery for colorectal cancer between 2010 and 2015. We compared long-term outcomes of a laparoscopic colorectal surgery group with those of an open colorectal surgery group by propensity score matching equalizing factors that could affect prognosis such as prognostic nutritional index and Charlson comorbidity index score.
Forty-eight pairs were selected after propensity score matching. The cancer-specific 5-year survival rate was 97.1% in the laparoscopic colorectal surgery group and 87.6% in the open colorectal surgery group (P = .17). The overall 5-year survival rate was 77.3% in the laparoscopic colorectal surgery group and 73.9% in the open colorectal surgery group (P = .32). The 5-year recurrence-free survival rate was 95.1% in the laparoscopic colorectal surgery group and 85.4% in the open colorectal surgery group (P = .14).
Laparoscopic colorectal surgery for octogenarians with colorectal cancer achieves similar oncological outcomes to open colorectal surgery and should be considered as a treatment option.
老年结直肠癌患者的数量逐渐增加。腹腔镜结直肠手术广泛应用于结直肠癌的治疗。本研究旨在评估 80 岁以上接受腹腔镜结直肠手术治疗结直肠癌患者的长期疗效。
本研究纳入了 2010 年至 2015 年期间接受结直肠癌手术的 158 例 80 岁以上的患者。我们通过倾向评分匹配,比较了腹腔镜结直肠手术组和开腹结直肠手术组的长期疗效,匹配了可能影响预后的因素,如预后营养指数和 Charlson 合并症指数评分。
倾向评分匹配后选择了 48 对。腹腔镜结直肠手术组的癌症特异性 5 年生存率为 97.1%,开腹结直肠手术组为 87.6%(P =.17)。腹腔镜结直肠手术组的总体 5 年生存率为 77.3%,开腹结直肠手术组为 73.9%(P =.32)。腹腔镜结直肠手术组的 5 年无复发生存率为 95.1%,开腹结直肠手术组为 85.4%(P =.14)。
对于 80 岁以上的结直肠癌患者,腹腔镜结直肠手术与开腹结直肠手术具有相似的肿瘤学疗效,应作为一种治疗选择。