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. 2021 Dec 28;14(1):131.
doi: 10.3390/cancers14010131.

Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score-Weighted Cohort Study

Yih-Jong Chern  1   2 , Jeng-Fu You  1   2 , Ching-Chung Cheng  1   2 , Jing-Rong Jhuang  3 , Chien-Yuh Yeh  1   2 , Pao-Shiu Hsieh  1   2 , Wen-Sy Tsai  1   2 , Chun-Kai Liao  1   2 , Yu-Jen Hsu  1   2
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Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score-Weighted Cohort Study

Yih-Jong Chern et al. Cancers (Basel). .

Abstract

Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I-III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.

Keywords: colorectal cancer; competing risk; elderly; laparoscopy surgery; outcome; propensity score.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Consort flow diagram of this study.
Figure 2
Figure 2
Overall survival and disease-free survival after propensity score weighting. (A). Disease-free survival; (B). Overall survival.
Figure 2
Figure 2
Overall survival and disease-free survival after propensity score weighting. (A). Disease-free survival; (B). Overall survival.
Figure 3
Figure 3
Cause-specific mortality after propensity score weighting. (A). Death from this cancer; (B). Death from other causes.
Figure 3
Figure 3
Cause-specific mortality after propensity score weighting. (A). Death from this cancer; (B). Death from other causes.
See this image and copyright information in PMC

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