Five‐Year Outcomes of Laparoscopic Sphincter‐Preserving Surgery for Rectal Cancer: A Prospective Study in Elderly Vietnamese Patients

ABSTRACT Objectives This prospective study aimed to assess the outcomes of laparoscopic sphincter‐preserving surgery in elderly patients with rectal cancer. Methods This study included patients over 65 years old with rectal cancer who underwent laparoscopic sphincter‐preserving surgery between 2015 and 2018. Patients with prior malignancies or abdominal surgeries were excluded. All patient data were collected, and the follow‐up was conducted over 5 years. Results A total of 78 patients underwent surgery with a median follow‐up of 65 months. The overall survival was approximately 80% at 3 years and 70% at 5 years. Notably, nearly half of the total deaths (11 out of 24) resulted from non‐cancer causes, including COVID‐19 and other comorbidities. Advanced T‐stage and tumor invasion were identified as the primary factors significantly associated with increased recurrence and mortality in univariate analyses. However, these factors did not remain statistically significant in multivariate models, likely due to the limited sample size of this geriatric cohort. Conclusion Laparoscopic sphincter‐preserving surgery is feasible for elderly patients, achieving a 70% 5‐year survival rate. However, the high recurrence risk in advanced T‐stage and invasive cases underscores the need for personalized geriatric protocols and more aggressive preoperative strategies for high‐risk subgroups.