Laparoscopic gastrectomy for elderly gastric-cancer patients: comparisons with laparoscopic gastrectomy in non-elderly patients and open gastrectomy in the elderly.

BACKGROUND

The benefits of laparoscopic gastrectomy (LG) in elderly gastric-cancer patients still remain unclear. The purpose of this study was to evaluate the feasibility and safety of LG in elderly gastric-cancer patients.

METHODS

We retrospectively evaluated patients who underwent LG or open gastrectomy (OG) between June 2009 and July 2015 in a single high-volume center. We compared surgical, short-term, and long-term survival outcomes among an elderly (≥70 years old) LG (ELG) group (=114), a non-elderly (<70 years old) LG (NLG) group (=740), and an elderly OG (EOG) group (=383).

RESULTS

Except for extended time to first flatus, the surgical and short-term outcomes of the ELG group were similar to those of the NLG group. The ELG group revealed comparable disease-specific survival (DSS) rates to the NLG group (64.9% vs 66.2%, =0.476), although the overall survival (OS) rate was lower (57.0% vs 65.5%, <0.001) in the ELG group than in the NLG group. The ELG group showed longer operation time than the EOG group (236.4 ± 77.3 vs 179 ± 52.2 min, <0.001). The ELG group had less estimated blood loss (174.0 ± 88.4 vs 209.3 ± 133.8, =0.008) and shorter post-operative hospital stay (8.3 ± 2.5 vs 9.2 ± 4.5, =0.048) than the EOG group. The severity of complications was similar between the ELG and NLG groups. Multivariate analysis confirmed that LG was not a risk factor for post-operative complications.

CONCLUSIONS

LG is a feasible and safe procedure for elderly patients with acceptable short- and long-term survival outcomes.