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World J Gastrointest Surg. Oct 27, 2026; 18(10): 123538
Published online Oct 27, 2026. doi: 10.4240/wjgs.123538
Published online Oct 27, 2026. doi: 10.4240/wjgs.123538
Minimally invasive rectal cancer surgery after neoadjuvant therapy in selected elderly and frail patients: A single-center real-world experience
Valentina Zucchini, Andrea Avanzolini, Department of General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Forli 47121, Emilia-Romagna, Italy
Leonardo Solaini, Giorgio Ercolani, Department of Medical and Surgical Sciences, University of Bologna, Bologna 40126, Emilia-Romagna, Italy
Author contributions: Zucchini V contributed to data curation, formal analysis, and writing of the original draft; Solaini L, Avanzolini A, and Ercolani G contributed to conceptualization; Solaini L and Ercolani G contributed to supervision; Avanzolini A contributed to data collection. All authors contributed to manuscript revision and approved the final version of the manuscript.
AI contribution statement: AI tools (ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Institutional review board statement: The study was reviewed and approved by the Comitato Etico di Area Vasta Emilia Centro, IRST-IRCCS, Meldola, Italy (approval No. 5956/2020, I.5/262).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The technical appendix, statistical code, and de-identified dataset are available from the corresponding author at leonardo.solaini2@unibo.it upon reasonable request, subject to approval by the local Ethics Committee and applicable data-protection regulations. Written informed consent for the collection and use of clinical data for research purposes was obtained from all patients.
Corresponding author: Leonardo Solaini, MD, Professor, Department of Medical and Surgical Sciences, University of Bologna, via Carlo Forlanini 34, Bologna 40126, Emilia-Romagna, Italy. leonardo.solaini2@unibo.it
Received: May 21, 2026
Revised: June 22, 2026
Accepted: July 9, 2026
Published online: October 27, 2026
Processing time: 141 Days and 11.3 Hours
Revised: June 22, 2026
Accepted: July 9, 2026
Published online: October 27, 2026
Processing time: 141 Days and 11.3 Hours
Core Tip
Core Tip: In this single-center real-world cohort, elderly and frail patients with rectal cancer who completed neoadjuvant therapy and were selected for curative-intent minimally invasive surgery achieved acceptable technical and oncologic outcomes. Patients aged 80 years or older had more medical and major postoperative complications and poorer overall survival, whereas surgical complications, cancer-specific survival, and disease-free survival were broadly comparable with those of younger patients. These findings support individualized multidisciplinary assessment rather than age-based exclusion in appropriately selected candidates.