Outcome of robotic colon surgery in older patients with colon cancer

Introduction

Older patients are less likely to undergo curative surgery for colon cancer (CC) because of a higher rate in comorbidities that increases the risk for complications and mortality. Robot-assisted surgery could be an alternative minimally invasive approach allowing surgical treatment in a higher percentage of patients above 70 years old. This study aims at evaluating the safety of robotic surgery in older patients with CC.

Materials and Methods

Prospectively collected data from all patients receiving robot-assisted surgery for CC at a tertiary center between 2016 and 2022 were used for retrospective subgroup analysis based on age and tumor location (right-sided, left-sided). Perioperative outcome including 30-day major morbidity and 90-day mortality rate, overall survival (OS) and cancer-specific survival (CSS) were compared.

Results

In total, 231 patients met inclusion criteria of the study: n = 89 < 70 years, n = 64 between 70 and 79 years, n = 72 between 80 and 89 years, and n = 6 ≥ 90 years. No differences in 90-day mortality or 30-day major morbidity were observed between age groups. Thirty-day overall morbidity, length of stay (LOS), and days to full mobility were increased in ≥70-year-olds for right- and left-sided surgery. One-, three-, and five-year CSS did not differ while the three- and five-year OS significantly decreased with age.

Discussion

Robot-assisted surgery for resection of CC can be used safely in older patients.