Comparison of Postoperative Outcomes of Laparoscopic Versus Open Gastrectomy in Older Patients With Gastric Cancer.

IF 1.6 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2025-04-01 DOI:10.21873/anticanres.17548

Tomohiro Takahashi, Tomoyuki Matsunaga, Hiroaki Saito, Tomohiro Osaki, Sadamu Takahashi, Akemi Iwamoto, Kenji Fukuda, Kenjiro Taniguchi, Hirohiko Kuroda, Tsutomu Takeuchi, Kenji Sugamura, Kenichi Sumi, Kuniyuki Katano, Shota Shimizu, Yuji Shishido, Kozo Miyatani, Teruhisa Sakamoto, Yoshiyuki Fujiwara

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引用次数: 0

Abstract

Background/aim: Several studies have investigated the safety of laparoscopic gastrectomy (LG) for gastric cancer (GC). However, many of these studies excluded older patients, and few multicenter studies have compared LG and open gastrectomy (OG) in older patients with GC. We compared the postoperative short- and long-term outcomes of LG and OG in >75 years old patients with GC in a multicenter study.

Patients and methods: The study included 926 patients aged >75 years who underwent gastrectomy from January 2003 to December 2017 at 12 regional hospitals. After propensity score-matching (PSM), the two surgical groups' short- and long-term outcomes were analyzed. PSM was applied for variables such as sex, depth of tumor invasion, lymph node metastasis, histologic type, pathological stage, gastrectomy, and lymph node dissection.

Results: After 1:1 matching, 258 cases in each group were analyzed. The LG group showed significantly longer surgery times and reduced blood loss (p<0.001). There were no significant differences in the incidence of postoperative complications graded Clavien-Dindo ≥ II between the groups (23.6% vs. 19.4%, p=0.239). However, the LG group had lower and higher incidences of pneumonia (1.9% vs. 5.4%, p=0.035) and pancreatic fistula (PF; 4.7% vs. 0.04%, p=0.003), respectively. The two groups had no significant overall and disease-specific survival differences across all stages.

Conclusion: In patients aged >75 years with GC, LG can be a viable approach with careful clinical management for the risk of PF, without compromising long-term survival.

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.