Safety and short-term outcomes of robotic surgery for colorectal cancer in the very elderly (≥ 85 Years): a multicenter propensity score-matched study.

PURPOSE: As the population ages, the demand for surgery in the elderly is increasing. This study aimed to evaluate the safety, short-term, and oncological outcomes of robot-assisted surgery for colorectal cancer in patients aged ≥ 85 years.

METHODS

We retrospectively analyzed 817 patients who underwent robotic surgery for colorectal cancer at seven institutions between 2016 and 2025. Patients were divided into an elderly group (≥ 85 years, n = 52) and a non-elderly group (< 85 years, n = 765). Propensity score matching was used to balance the baseline characteristics, resulting in 52 matched patients per group.

RESULTS

After matching, no significant differences were observed in operative time (238 vs. 255 min, p = 0.198), blood loss (18 vs. 10 mL, p = 0.740), or the number of retrieved lymph nodes (15 vs. 16, p = 0.977). Postoperative complication rates (Clavien-Dindo grade ≥ II) were comparable between the elderly and non-elderly groups (9.6% vs. 13.5%, p = 0.760). Furthermore, the 3-year recurrence-free survival (100% vs. 96.1%, p = 0.482) and overall survival (88.1% vs. 95.6%, p = 0.244) were not significantly different between the groups.

CONCLUSIONS

Robotic surgery for colorectal cancer is safe and feasible in carefully selected patients aged ≥ 85 years. Surgical indications should be determined based on individualized assessments rather than chronological age alone.