Is Laparoscopic Gastrectomy More Advantageous for Elderly Patients Than for Young Patients with Resectable Advanced Gastric Cancer?

被引:18
作者
Ushimaru, Yuki [1 ]
Kurokawa, Yukinori [1 ]
Takahashi, Tsuyoshi [1 ]
Saito, Takuro [1 ]
Yamashita, Kotaro [1 ]
Tanaka, Koji [1 ]
Makino, Tomoki [1 ]
Yamasaki, Makoto [1 ]
Nakajima, Kiyokazu [1 ]
Mori, Masaki [2 ]
Doki, Yuichiro [1 ]
机构
[1] Osaka Univ, Grad Sch Med, Dept Gastroenterol Surg, 2-2-E2 Yamadaoka, Suita, Osaka 5650871, Japan
[2] Kyushu Univ, Grad Sch Med, Dept Surg & Sci, Fukuoka, Japan
关键词
ASSISTED DISTAL GASTRECTOMY; LONG-TERM OUTCOMES; SUPRAPANCREATIC NODAL DISSECTION; PHASE-II; POSTOPERATIVE COMPLICATIONS; SURGICAL OUTCOMES; SURGERY; SURVIVAL; FEASIBILITY; FRAILTY;
D O I
10.1007/s00268-020-05486-2
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Laparoscopic gastrectomy (LG) is now practiced widely, but it is unclear whether LG is the appropriate approach for elderly patients with resectable advanced gastric cancer. The aim of this study was to examine whether LG is more or less advantageous for elderly patients than for young patients. Methods We collected data on 571 consecutive patients who underwent gastrectomy for pT2-4 gastric cancer between January 2001 and December 2015. After adjustment with one-to-one propensity score matching, short-term and long-term outcomes were compared between the LG and open gastrectomy (OG) groups among young (age < 70 years) and elderly (age >= 70 years) patients. Results The LG group had a significantly longer operative time (P < 0.001) and less blood loss (P < 0.001) than the OG group among young and elderly patients. There were no significant differences regarding complications. Although disease-specific survival was similar between the LG and OG groups among young and elderly patients, LG was associated with more favorable overall survival than OG only among elderly patients (hazard ratio 0.67; 95% confidence interval 0.35-1.26). Death from respiratory diseases occurred more frequently in the OG group (10.9%) than in the LG group (0%) for elderly patients (P = 0.012). Conclusion LG for resectable advanced gastric cancer was not inferior to OG in terms of both short-term and long-term outcomes regardless of patient age. In elderly patients, LG may improve overall survival by reducing mortality from respiratory diseases.
引用
收藏
页码:2332 / 2339
页数:8
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