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Outcomes of laparoscopic total gastrectomy in elderly patients: a propensity score matching analysis

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Abstract

Purpose

This study evaluated the short-term outcomes and prognosis after laparoscopic total gastrectomy (LTG) in elderly patients aged ≥ 80 years in a multicenter retrospective cohort study using propensity score matching.

Methods

We retrospectively enrolled 440 patients who underwent curative LTG for gastric cancer at six institutions between January 2004 and December 2018. Patients were categorized into an elderly patient group (EG; age ≥ 80 years) and non-elderly patient group (non-EG; age < 80 years). Patients were matched using the following propensity score covariates: sex, body mass index, American Society of Anesthesiologists physical status, extent of lymph node dissection, and Japanese Classification of Gastric Carcinoma stage. Short-term outcomes and prognoses were compared.

Results

We identified 37 propensity score-matched pairs. The median operative time was significantly shorter, and postoperative stay was longer in the EG. In terms of postoperative outcomes, the rates of all complications were comparable. The median follow-up period of the EG and non-EG was 11.5 (1–106.4) months and 35.7 (1–110.0) months, respectively; there were significant differences in 5-year overall survival between the two groups (EG, 58.5% vs. non-EG, 91.5%; P = 0.031). However, there were no significant differences in 5-year disease-specific survival (EG, 62.1% vs. non-EG, 91.5%; P = 0.068) or 5-year disease-free survival (EG, 52.9% vs. non-EG, 60.8%; P = 0.132).

Conclusions

LTG seems to be safe and feasible in elderly patients. LTG had a limited effect on morbidity, disease recurrence, and survival in elderly patients. Therefore, age should not prevent elderly patients from benefitting from LTG.

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Data availability

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

The author is grateful to our colleagues (Dr. Hiroshi Kawase, Noriaki Kyogoku, and Mamoru Miyasaka) and the interdisciplinary surgical team. We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan

    Yuma Ebihara, Yo Kurashima, Yusuke Watanabe, Kimitaka Tanaka, Aya Matsui, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Toru Nakamura, Soichi Murakami, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe & Satoshi Hirano

  2. Division of Minimally Invasive Surgery, Hokkaido University Hospital, Sapporo, Japan

    Yuma Ebihara

  3. Department of Surgery, Asahikawa City Hospital, Asahikawa, Japan

    Yoshihiro Murakami

  4. Department of Surgery, Obihiro-Kosei General Hospital, Obihiro, Japan

    Katsuhiko Murakawa

  5. Department of Surgery, Teine Keijinkai Hospital, Sapporo, Japan

    Fumitaka Nakamura

  6. Department of Surgery, Hokkaido Gastroenterology Hospital, Sapporo, Japan

    Takayuki Morita

  7. Department of Surgery, Tonan Hospital, Sapporo, Japan

    Shunichi Okushiba

Authors
  1. Yuma Ebihara
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  19. Satoshi Hirano
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Contributions

Study conception and design: Yuma Ebihara and Yo Kurashima.

Acquisition of data: Yuma Ebihara.

Analysis and interpretation of data: Yuma Ebihara and Yo Kurashima.

Drafting of manuscript: Yuma Ebihara.

Critical revision of the manuscript: Yuma Ebihara, Yo Kurashima, Yusuke Watanabe, Kimitaka Tanaka, Aya Matsui, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Toru Nakamura, Soichi Murakami, Takahiro Tsuchikawa, Keisuke Okamura, Yoshihiro Murakami, Katsuhiko Murakawa, Fumitaka Nakamura, Takayuki Morita, Shunichi Okushiba, Toshiaki Shichinohe, and Satoshi Hirano.

Corresponding author

Correspondence to Yuma Ebihara.

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Hokkaido University Hospital Institutional Review Board approved the data collection and analysis (No. 016–0151).

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The authors declare no competing interests.

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Ebihara, Y., Kurashima, Y., Watanabe, Y. et al. Outcomes of laparoscopic total gastrectomy in elderly patients: a propensity score matching analysis. Langenbecks Arch Surg 407, 1461–1469 (2022). https://doi.org/10.1007/s00423-022-02447-2

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