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. 2017 Nov;7(5):771-776.
doi: 10.3892/mco.2017.1419. Epub 2017 Sep 19.

Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Wang Fugang  1   2 , Yu Zhaopeng  1   2 , Zhao Meng  2 , Song Maomin  2
Affiliations

Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Wang Fugang et al. Mol Clin Oncol. 2017 Nov.

Abstract

The long-term outcome of laparoscopic surgery for geriatric patients with colorectal cancer remains unclear due to decreased functional reserves and increased medical comorbidities. A meta-analysis was performed in the present study to compare the long-term outcome between laparoscopy and laparotomy. Randomized controlled trials and comparative studies regarding laparoscopy vs. open surgery for colorectal cancer in elderly patients were searched in Pubmed, Embase, and Cochrane library between inception and April 20, 2017. The methodological quality of the cohort studies was evaluated using the Newcastle-Ottawa Scale. The meta-analysis was performed using Stata v12.0 software. Eight cohort studies were enrolled in the meta-analysis. Laparoscopic surgery was associated with a higher 3-year survival rate compared with open surgery [risk ratio (RR), 0.74; 95% confidence interval (CI), 0.61-0.90; P=0.003]. No significant difference was identified between laparoscopy and laparotomy regarding the 5-year survival rate (RR, 0.93; 95% CI, 0.78-1.11, P=0.424). The results of the meta-analysis indicated that the use of laparoscopic surgery on geriatric patients with colorectal cancer should be increased due to more improved long-term outcomes. All the studies included in the meta-analysis were case-control studies with selection bias and other confounding factors. Thus, larger sample sizes and multicenter randomized controlled trials are required to further validate the use of laparoscopic surgery as the preferred therapeutic option for elderly patients with colorectal cancer.

Keywords: colorectal neoplasms; elderly; laparoscopic; open surgery.

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Figures

Figure 1.
Figure 1.
Flowchart of procedure selection.
Figure 2.
Figure 2.
Meta-analysis of 3-year survival rate. RR, risk ratio; CI, confidence interval.
Figure 3.
Figure 3.
Meta-analysis of 5-year survival rate. RR, risk ratio; CI, confidence interval.
Figure 4.
Figure 4.
Funnel graph of included studies. SE, standard error; logrr, log risk ratio.
See this image and copyright information in PMC

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