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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 11/2015

01-11-2015 | Original Article

Short- and Long-Term Outcomes After Laparoscopic Versus Open Total Gastrectomy for Elderly Gastric Cancer Patients: a Propensity Score-Matched Analysis

Authors: Jun Lu, Chang-ming Huang, Chao-hui Zheng, Ping Li, Jian-wei Xie, Jia-bin Wang, Jian-xian Lin, Qi-yue Chen, Long-long Cao, Mi Lin

Published in: Journal of Gastrointestinal Surgery | Issue 11/2015

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Abstract

Background

To date, it has been unclear whether laparoscopic-assisted total gastrectomy (LTG) was a suitable treatment for elderly patients (aged 65 years and older) with gastric cancer. The aim of the present study was to clarify the value of LTG in the elderly using a propensity score matching method.

Methods

We prospectively collected data from 675 elderly gastric cancer patients who underwent total gastrectomies at our institution between January 2002 and February 2012. Propensity score matching was applied at a ratio of 1:1 to compare the LTG and open total gastrectomy (OTG) groups. The operation results, hospital courses, and survival rates were compared between the matched groups.

Results

The LTG group had a significantly shorter mean operating time (194 vs. 267 min, P < 0.001) and significantly less intraoperative blood loss (92 vs. 204 ml, P < 0.001). The total number of collected lymph nodes was similar in the two groups. Postoperatively, the length of hospital stay was shorter in the LTG group than in the OTG group (median 14.4 vs. 16.6 days; P = 0.001); however, no significant intergroup differences were found in morbidity or mortality. Furthermore, the 3-year overall survival (OS) rate was similar between the two groups (P = 0.517).

Conclusions

LTG for elderly gastric cancer is feasible and safe with acceptable oncologic outcomes. Therefore, patient age alone should not be considered a contraindication in the decision between LTG and OTG treatment options. A high-volume prospective study is needed to confirm this rationale.
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Metadata
Title
Short- and Long-Term Outcomes After Laparoscopic Versus Open Total Gastrectomy for Elderly Gastric Cancer Patients: a Propensity Score-Matched Analysis
Authors
Jun Lu
Chang-ming Huang
Chao-hui Zheng
Ping Li
Jian-wei Xie
Jia-bin Wang
Jian-xian Lin
Qi-yue Chen
Long-long Cao
Mi Lin
Publication date
01-11-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 11/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2912-2

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