Short- and long-term outcomes of laparoscopic surgery in elderly patients with rectal cancer.

PURPOSE: This study aimed to use propensity score matching (PSM) to compare the short- and long-term outcomes of laparoscopic surgery for the treatment of rectal cancer in elderly and middle-aged patients.

METHODS: Data were retrospectively obtained from 588 patients aged ≥60 years when they underwent laparoscopic surgery for rectal cancer in our hospital between January 2009 and December 2016. The patients were divided into an elderly group (≥70 years) or a middle-aged group (60-69 years), and were subsequently matched 1:1 using PSM for sex, body mass index, Charlson comorbidity index (CCI), tumor location, clinical stage, and American Society of Anesthesiologists (ASA) score. A total of 115 patients from each group were matched and included in the study, and their short-term and long-term outcomes were compared.

RESULTS: The elderly group had greater intraoperative blood loss and a higher surgical conversion rate, although the other outcomes were similar between the two groups (surgical time, pathology results, 30-day incidence of complications, and incidence of major complications). No patients died intraoperatively or within 30 days after surgery. There were no significant differences in the two groups' rates of tumor recurrence, 5-year overall survival, and 5-year disease-free survival.

CONCLUSION: Although elderly patients had greater intraoperative blood loss and a higher surgical conversion rate, laparoscopic surgery for rectal cancer provided similar short-term and long-term outcomes among middle-aged and elderly patients.