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

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.

Automated summary

This study found that laparoscopic gastrectomy (LG) for elderly patients aged 80 years and older with gastric cancer had better short-term and long-term outcomes compared to open gastrectomy (OG), including faster recovery, shorter hospital stay, lower complication rate, and slightly higher survival rates without significant differences.