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.