Comparative benefits of laparoscopic surgery for colorectal cancer in octogenarians: a case-matched comparison of short- and long-term outcomes with middle-aged patients

Purpose The aim of this study was to compare the postoperative short- and long-term outcomes after laparoscopic colorectal surgery (LCS) between octogenarians and healthy middle-aged patients. Methods Between January 1997 and July 2009, 655 consecutive laparoscopic surgeries for colorectal cancer patients were operated by 1 colorectal surgeon. Ninety-three patients were octogenarians >= 80 years), and 133 patients were case-matched middle-aged (60-69 years) patients. We analyzed the mean operative time, blood loss, type of surgery for rectal cancer, length of hospital stay, mortality, and morbidity. The overall survival curve was constructed using the Kaplan-Meier method. Results The American Society of Anesthesiologists classification was significantly higher in the octogenarians than in the middle-aged controls. However, there were no significant differences between the two groups in terms of the incidence of morbidities (11.7 vs. 9.2 %) and length of hospital stay (12.1 vs. 10.9 days). The number of lymph nodes harvested was significantly fewer (p < 0.05) and the operative time significantly shorter (p < 0.05) in the octogenarians than in the middle-aged controls. At a mean follow-up of 38.2 months, the overall 5-year survival rate was 64.8 % in the octogenarians and 92.4 % in the middle-aged group, whereas the cancer-specific 5-year survival rate was 91 % in the octogenarians and 95.7 % in the middle-aged group. Conclusion We suggest that advanced age should not be a contraindication for LCS, even for complex procedures, such as laparoscopic rectal resection.