Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiation in Elderly Patients

Choi, Je Min; Lee, Seung Hun; Lee, Seung Hyun; Ahn, Byung Kwon

Abstract

PURPOSE
Laparoscopic surgery has been accepted as a standard procedure for colorectal cancer. Preoperative chemoradiation for rectal cancer has some advantages, such as decreased tumor size and lower stage, and lower local recurrence. However, preoperative chemoradiation has the disadvantage of increasing postoperative complication risks. The aim of this study was to evaluate the safety of laparoscopic surgery for rectal cancer after preoperative chemoradiation in elderly patients.
METHODS
46 p atients u nderwent l aparoscopic s urgery for rectal c ancer a fter preoperative chemoradiation. Patients were divided into younger (<70 years, n=35) and older groups (â‰¥70 years, n=11).
RESULTS
In the younger group, men were more predominant (80% vs. 54.5%, p=0.124). In the older group, more patients had high American Society of Anesthesiologists scores (score 3 was 2.9% vs. 36.4%, p=0.005) than in the younger group. Sphincter-preserving surgery was performed more frequently in the younger group (77.2% vs. 45.5%, p=0.065). Operation time (195.8 min. vs. 212.5 min, p=0.553) and intraoperative blood loss (200.6 cc vs. 209.1 cc, p=0.952) were not significantly different. Significant anastomotic leakage was absent in both groups. Postoperative hospital stay was 9.7 and 10.9 days (p=0.669). Complete remission rates were similar in the both groups (8.8% vs. 18.2%, p=0.824).
CONCLUSION
Postoperative outcomes are comparable between older group and younger group. Laparoscopic surgery could be considered as safe, feasible therapeutic options in elderly patients after preoperative chemoradiation for rectal cancer. However, large randomized trials with comparative methodologies are needed.