An optimal therapeutic paradigm for older colorectal cancer patients (ASA-PS 3) in terms of surgical outcomes

Aim To define optimal therapeutic paradigms for older patients with colorectal cancer (CRC) and an American Society of Anesthesiologists Physical Status (ASA-PS) of 3 based on surgical outcomes.Methods This retrospective study enrolled older patients undergoing surgical intervention for CRC. Data were obtained from institutional medical records, and immediate and long-term outcomes were analyzed.Results From 2016–2021, 47 individuals aged ≥65 years (71% male), classified as ASA-PS ≥3, received laparoscopic (n = 27) or open (n = 20) surgery. Univariate analysis revealed shorter postoperative hospital stay (p = 0.073), higher curative resection rate (p = 0.030), and lower recurrence-free survival (p = 0.100) in the laparoscopic group.Conclusion The findings of this study suggest that laparoscopic surgery is a useful and effective surgical approach for older patients with poor ASA-PS scores undergoing colorectal cancer surgery. The significantly higher R0 resection rate and comparable recurrence rate indicate that laparoscopic surgery can be a viable option for curative resection in this population. Although the shorter length of postoperative hospital stay observed in the laparoscopic group was not statistically significant, the trend toward reduced hospitalization suggested potential benefits for postoperative recovery.