Long-term Results after Laparoscopic Resection for Colorectal Cancer within a Fast-track Regimen in the Elderly: A Prospective Study

ABSTRACT

Introduction: Trials of laparoscopic surgery for colorectal cancer in elderly with co-morbidity are needed. The aim of the present study was to evaluate the oncologic outcome after laparoscopic resection for non-metastatic colorectal cancer within a fast-track regimen comparing patients ≥ 75 years of age to patients < 75 years of age. Methods: A total of 55 patients were laparoscopically operated upon for non-metastatic colorectal cancer in February 2001- March 2003. Twenty-nine patients were ≥ 75 years old and 26 were younger. All patients had a perioperative fasttrack regimen. They were followed up for median 60 months. Results: The two age groups were comparable with regard to sex distribution, operative procedures and cancer stage. The co-morbidity (ASA score) was higher in the elderly group (p=0.05) as well as the perioperative complication rate, 24 vs. 15% (p=0.3). The five-year overall survival was 66% in the elderly group vs. 69% in the younger group (p=0.9). The disease- free survival was 62 vs.69%, respectively (p=0.1). The recurrence rate was 7 vs. 19%, respectively (p=0.2). For all the patients together the recurrence rate was 13% with no significant differences between the stage groups (p=0.4). Conclusion: Laparoscopic surgery and fast-track regimen together seem to have a beneficial effect on long-term oncologic outcome in the elderly.