Operative and Survival Outcomes of Robotic-Assisted Surgery for Colorectal Cancer in Elderly and Very Elderly Patients: A Study in a Tertiary Hospital in South Koreaopen access
- Authors
- Cuellar-Gomez, Hugo; Rusli, Siti Mayuha; Ocharan-Hernández, María Esther; Lee, Tae-Hoon; Piozzi, Guglielmo Niccolò; Kim, Seon-Hahn; Vargas-De-León, Cruz
- Issue Date
- Jan-2022
- Publisher
- Hindawi Publishing Corporation
- Citation
- Journal of Oncology, v.2022
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Oncology
- Volume
- 2022
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64807
- DOI
- 10.1155/2022/7043380
- ISSN
- 1687-8450
1687-8469
- Abstract
- Introduction and Objectives. Most patients with colorectal cancer are elderly. Literature is scarce on elderly patients submitted to robotic-assisted surgery, despite the feasibility shown in other age groups. The aim of this study was to evaluate the postoperative and survival outcomes of robotic-assisted colorectal cancer surgery in elderly patients. Materials and Methods. Data of all patients ≥75 years who underwent a robotic-assisted curative resection in Korea University Anam Hospital, Seoul, South Korea, between January 2007 and January 2021 were extracted from a prospectively maintained colorectal cancer database. Patients were subdivided into the three groups according to the age: youngest-old (YO: 75-80 years), middle-old (MO: 81-85), and oldest-old (OO: ≥86 years). Intraoperative findings, postoperative, and oncological outcomes were compared between the groups. Results. Seventy-six consecutive patients (female 52.6%) were included; mean age was 80 years (SD 0.33); mean body mass index (BMI), 23.8 20.9 kg/m2 (SD 3.58); mean total operative time, 279 min (SD 80.93); mean blood loss, 186 ml (SD 204.03); mean postoperative length of stay, 14 days (SD 12.03). Major complications were seen in 2.1% of patients. The 30-day mortality rate was 0%. Average number of lymph node harvested was 20.9 (SD 12.33). Postoperative complications were not statistically different between the groups. Mean follow-up time for cancer-specific survival (CSS) was 99.28 months for the YO, 72.11 months for MO, and 31.25 months for OO groups (p = 0.045). The CSS rates at 5 years were 27.0%, 21.0%, and 0%, respectively. Recurrence risk was 10.50 times higher in the OO group than the others (adjusted HR, 95% CI 1.868-59.047, p = 0.008). In the multivariable analysis, TNM stage was not a risk factor for CSS in all groups. The number of the harvested nodes was a protective factor for recurrence (HR of 0.932, 95% CI 0.875-0.992, p = 0.027) and CSS (HR of 0.928, 95% CI 0.861-0.999, p = 0.047) in elderly patients. Conclusion. Robotic surgery is highly feasible in elderly and very elderly colorectal cancer patients, providing a favorable operative safety profile and an acceptable cancer-specific survival outcome. © 2022 Hugo Cuellar-Gomez et al.
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