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Article

Laparoscopic versus Open Colectomy for Elderly Patients with Colon Cancer: A Propensity Score Analysis with the Controlling Nutritional Status (CONUT) Score

, , , , , , , , & show all
Pages 246-251 | Received 25 Jul 2019, Accepted 12 Feb 2020, Published online: 07 Apr 2020
 

Abstract

The feasibility of laparoscopic surgery for elderly patients remains unclear, as these patients usually present with comorbidities. Recently, the controlling nutritional status (CONUT) score has drawn attention as an evaluation score of patients’ general status as well as a predictor of survival. We retrospectively analyzed overall survival in 424 patients aged ≥75 years with colon cancer, who underwent curative surgery (laparoscopic (n = 167) or open surgery (n = 257)) between January 2004 and December 2013. To adjust for heterogeneity in both groups, a propensity score-matched analysis was performed, with the CONUT score as a confounding covariate. 5-year overall survival rates of patients with normal (0–1), mildly abnormal (2–4), or abnormal (≥5) CONUT score were 88.6%, 79.4%, and 41.4%, respectively (p < 0.001). T3 or less, N negative, late period (2009–2013), and normal CONUT score were associated with the tendency to undergo laparoscopic surgery (p < 0.001). The analysis of the propensity score-matched cohort (124 pairs) revealed that patients in the laparoscopic surgery group had a similar prognosis to those in the open surgery group, with a 5-year overall survival of 91.9% vs. 82.0%, respectively (p = 0.102). Laparoscopic surgery for colon cancer is an acceptable surgical approach in elderly patients.

Acknowledgments

The authors also thank all of their et al., and nurses who took care of their patients.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Authors Contribution

HT designed the study and drafting the work. DS convinced of the study, participated in its design and coordination, and were responsible for writing the paper and for its supervision. YA, YT, MI, TT, YN, JI, ST and YK collected the data, performed the treatments and revised the work critically. All authors read and approved the final manuscript.

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