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Advantages of Laparoscopic Surgery for Gastric Cancer in Elderly Patients Aged Over 80 Years: A Propensity Score Matching Analysis

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Abstract

Background

The short- and long-term efficacy of laparoscopic surgery for elderly patients with gastric cancer has not been evaluated. We aimed to use propensity score matching to clarify the efficacy of laparoscopic gastrectomy (LG) for elderly patients with gastric cancer aged ≥80 years.

Methods

We retrospectively collected data from 159 consecutive patients with gastric cancer aged ≥80 years who underwent gastrectomy with curative intent at our institution between 2004 and 2015. Propensity score matching was applied to compare the open gastrectomy (OG) and LG. Short- and long-term outcomes were evaluated between the propensity-matched groups.

Results

Patients’ backgrounds and surgical factors were similar in both groups except for blood loss. The median time to first flatus was significantly shorter in the LG group than in the OG group (P = 0.002). The postoperative hospital stay was significantly shorter in the LG group (P = 0.014). The complication rate of Clavien–Dindo grade III or higher was significantly lower in the LG group (3% vs. 23%, P = 0.023). The 5-year overall survival and 5-year disease-specific survival rates were better in the LG group than in the OG group, but the differences were not significant (45% vs. 42% and 67% vs 57%, respectively).

Conclusion

LG was associated with good short-term outcomes and acceptable oncologic outcomes compared with OG in these propensity-matched patients aged ≥80 years.

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Acknowledgements

The authors had no financial support for the research reported.

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Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan

    Ryo Tanaka, Sang-Woong Lee, Yoshiro Imai, Kotaro Honda, Kentaro Matsuo, Keitaro Tashiro, Masaru Kawai & Kazuhisa Uchiyama

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  1. Ryo Tanaka
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  2. Sang-Woong Lee
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  3. Yoshiro Imai
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  4. Kotaro Honda
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  8. Kazuhisa Uchiyama
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Correspondence to Ryo Tanaka.

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This study was approved by the Institutional Review Board of Osaka Medical College Hospital.

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Tanaka, R., Lee, SW., Imai, Y. et al. Advantages of Laparoscopic Surgery for Gastric Cancer in Elderly Patients Aged Over 80 Years: A Propensity Score Matching Analysis. World J Surg 45, 2830–2839 (2021). https://doi.org/10.1007/s00268-021-06157-6

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