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Anterior laparoscopic rectal resection for cancer in the elderly:
long-term outcome, risk factors and health related quality of life
, Silvia Savastano
, Giacomo Sarzo
, Mario Gruppo
, Isabella Mondi
, Francesco Cavallin
, Elisa Marcellan
and Stefano Merigliano
University of Padua, Department of Surgical and Gastroenterologic Sciences, 3th General Surgery Clinic, Coloproctological Unit, "S.
Antonio" Hospital, Italy and
Istituto Oncologico Veneto (IOV-IRCCS), Padua, Italy
* Corresponding author
Elderly population in Western countries is rapidly increas-
ing. Literature suggests that radical colorectal resection in
the elderly can be safely undertaken with good short and
long term results; however results of specific rectal laparo-
scopic resections are not well defined and so quality of
life. The aim of this study was to assess long-term out-
come; risk factors and health related quality of life
(HRQoL) in elective rectal cancer laparoscopic resection
in patients older than 65 years.
Materials and methods
Between March 2002 and November 2007, 57 patients
underwent elective laparoscopic resection for rectal can-
cer. Of these 32 (56%) were 65 years of age or older; the
remaining 25 were the control group. Perioperative and
follow-up data were collected and stored in a database.
We assessed: operative findings, histopathological fea-
tures, postoperative course, follow-up and overall sur-
vival. All patients were assessed using the EORTC QLQ
C30 and EORTC QLQC38 questionnaire to establish
Laparoscopic resection for rectal cancer in the elderly is
safe with no perioperative mortality and post-operative
morbidity similar to younger patients (7%vs13%; p =
The overall survival was lower in the younger patients (p
= 0.0015; the 5-year overall survival rates were 69% vs
96.4%); but age older than 65 years was not an independ-
ent risk factor for overall survival at the multivariate anal-
The multivariate analysis showed that neoadjuvant radio-
therapy (p = 0.04) and metastatic nodes (p = 0.006) are
independent risk factor for overall survival and vascular
invasion (p = 0.005) for local recurrence. HRQoL was sim-
ilar in the two groups.
Laparoscopic rectal resection for old patients is safe, with
short-term results comparable to that of younger people.
Old age is not an independent risk factor for prognosis.
We achieved excellent overall long term survival and a
good quality of life.
from XXI Annual Meeting of The Italian Society of Geriatric Surgery
Terni, Italy. 4–6 December 2008
Published: 1 April 2009
BMC Geriatrics 2009, 9(Suppl 1):A43 doi:10.1186/1471-2318-9-S1-A43
<supplement> <title> <p>XXI Annual Meeting of The Italian Society of Geriatric Surgery</p> </title> <editor>Francesco Sciannameo, Giammario G iustozzi and Beatrice Sen si</editor> <sponsor> <n ote>Publication of this s upplement was made possib le with support from the Fondazione Cassa di Risparmio di Terni e Narni</note> </sponsor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biom edcentral.com/content/fi les/pdf/1471-2318-9-S1-full .pdf">here</a>.</note> < url>http://www.biomedc entral.com/content/pdf/ 1471-2318-9-S1-info.pdf</u rl> </supplement>
This abstract is available from: http://www.biomedcentral.com/1471-2318/9/S1/A43
© 2009 Vecchiato et al; licensee BioMed Central Ltd.