Advantage of Laparoscopy Surgery for Elderly Colorectal Cancer Patients without Compromising Oncologic Outcome

Chern, Yih-Jong; Hung, Hsin-Yuan; You, Jeng-Fu; Hsu, Yu-Jen; Chiang, Jy-Ming; Hsieh, Pao-Shiu; Tsai, Wen‐Sy

doi:10.21203/rs.3.rs-27987/v1

Cited by 2 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This lack of difference in complications might play a role in the lack of difference in survival. The conversion rate was 3%, similar to that of a previous study (2%) (29).…”

Section: Discussionsupporting

confidence: 88%

“…In this study of middle-aged patients with CRC, there were no differences in OS and DFS in all patients after matching with age, gender, BMI, tumor location, AJCC stage, and admission year. LR has become an accepted therapeutic option for CRC patients, providing similar OS and DFS compared with OR in stages I-III disease (22)(23)(24)(25)(26)(27)(28)(29), supporting the present results. Previous studies in patients with CRC (irrespective of age, but most studies included older patients) showed that LR was at least comparable to OR, as shown by two meta-analyses (7,30), supporting the present study.…”

Section: Discussionsupporting

confidence: 85%

See 1 more Smart Citation

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

Bao

Deng

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: The prognosis of middle-aged patients with CRC treated by laparoscopic resection (LR) is unclear. This study aimed to evaluate the survival outcomes of LR compared with open resection (OR) for patients with CRC and 45-65 years of age.Methods: This retrospective cohort study used the data from a database of all consecutive colorectal resections performed between January 2009 and December 2017. Propensity score matching (PSM) was done to handle the selection bias based on age, gender, body mass index (BMI), tumor location, AJCC stage, and admission year. Univariate and multivariate COX regression model was used to identify risk factors of overall survival (OS) and progression-free survival (PFS).Results: After PSM, 217 patients were included in each group. There were no differences in OS and PFS between the two groups (all P>0.05). There was less blood loss for LR (P<0.001), but the other complications were similar between the two groups. The multivariate analysis showed that high histological grade (hazard ratio [HR]=2.262, 95%CI: 1.334-3.836, P=0.002), stage III (HR=1.744, 95%CI: 2.360-25.406, P=0.001), stage IV (HR=47.905, 95%CI: 14.430-159.033, P<0.001), and adjuvant therapy (HR=0.547, 95%CI: 0.358-0.838, P=0.006) were independently associated with OS. High preoperative CEA (HR=1.585, 95%CI: 1.049-2.394, P=0.029), high histological grade (HR=2.128, 95%CI: 1.272-3.558, P=0.004), stage III (HR=5.562, 95%CI: 1.980-15.624, P=0.001), and stage IV (HR=26.338, 95%CI: 9.090-76.315, P<0.001), were independently associated with OS. LR was not associated with OS and PFS.Conclusions: In middle-aged patients with CRC, OR and LR have similar survival outcomes and complications.

show abstract

“…This lack of difference in complications might play a role in the lack of difference in survival. The conversion rate was 3%, similar to that of a previous study (2%) (29).…”

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 85%

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

Bao

Deng

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…A minimally invasive approach is nowadays considered the treatment of choice of colorectal malignancies, being associated with low postoperative comorbidities and short length of hospital stay [ 20 , 21 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic Colorectal Cancer Surgery. How to Reach Expertise? A Single Surgeon-Experience

Manigrasso

Vertaldi

Anoldo

et al. 2021

JPM

View full text Add to dashboard Cite

The complexity associated with laparoscopic colorectal surgery requires several skills to overcome the technical difficulties related to this procedure. To overcome the technical challenges of laparoscopic surgery, a robotic approach has been introduced. Our study reports the surgical outcomes obtained by the transition from laparoscopic to robotic approach in colorectal cancer surgery to establish in which type of approach the proficiency is easier to reach. Data about the first consecutive 15 laparoscopic and the first 15 consecutive robotic cases are extracted, adopting as a comparator of proficiency the last 15 laparoscopic colorectal resections for cancer. The variables studied are operative time, number of harvested nodes, conversion rate, postoperative complications, recovery outcomes. Our analysis includes 15 patients per group. Our results show that operative time is significantly longer in the first 15 laparoscopic cases (p = 0.001). A significantly lower number of harvested nodes was retrieved in the first 15 laparoscopic cases (p = 0.003). Clavien Dindo I complication rate was higher in the first laparoscopic group, but without a significant difference among the three groups (p = 0.09). Our results show that the surgeon needed no apparent learning curve to reach their laparoscopic standards. However, further multicentric prospective studies are needed to confirm this conclusion.

show abstract

Advantage of Laparoscopy Surgery for Elderly Colorectal Cancer Patients without Compromising Oncologic Outcome

Cited by 2 publications

References 28 publications

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

Robotic Colorectal Cancer Surgery. How to Reach Expertise? A Single Surgeon-Experience

Contact Info

Product

Resources

About