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Laparoscopic versus open resection for elderly patients with gastric cancer: a double-center study with propensity score matching method

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Abstract

Purpose

The applicability of laparoscopic-assisted radical gastrectomy for elderly patients with gastric cancer is still not well clarified. The aim of this double-center study was to explore the feasibility and effectiveness of laparoscopic-assisted radical gastrectomy on elderly patients with gastric cancer.

Methods

We prospectively collected data of patients who underwent gastrectomy for cancer in two centers from June 2016 to December 2019. Propensity score matching was performed at a ratio of 1:1 to compare the laparoscopic-assisted radical gastrectomy group and open radical gastrectomy group. Univariate analyses and multivariate logistic regression analyses evaluating the risk factors for total, surgical, and medical complications were performed.

Results

A total of 481 patients with gastric cancer met the inclusion criteria and were included in this study. After propensity score analysis, 258 patients were matched each other (laparoscopic-assisted radical gastrectomy (LAG) group, n = 129; open radical gastrectomy (OG) group, n = 129). LAG group had lower rate of surgical complications (P = 0.009), lower rate of severe complications (P = 0.046), shorter postoperative hospital stay (P = 0.001), and lower readmission rate (P = 0.039). Multivariate analyses revealed that anemia, Charlson comorbidity index, and combined resection were independent risk factors in the LAG group, whereas body mass index and American Society of Anesthesiology grade in the OG group.

Conclusion

Laparoscopic-assisted radical gastrectomy was relative safe even effective in elderly gastric cancer patients. We should pay attention to the different risk factors when performing different surgical procedures for gastric cancer in elderly patients.

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Funding

This study was funded by the Natural Science Foundation of Zhejiang Province (No. Y15H160190).

Author information

Author notes

  1. Wei-Zhe Chen and Qian-Tong Dong have contributed equally to this work and are co-first authors on this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China

    Wei-Zhe Chen, Qian-Tong Dong, Feng-Min Zhang, Hui-Yang Cai, Jing-Yi Yan & Xiao-Lei Chen

  2. Department of Gastrointestinal Surgery, Shanghai Tenth People’s Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, 20072, China

    Cheng-Le Zhuang & Zhen Yu

  3. Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, The South of Shangcai Village, Ouhai District, Wenzhou, 325005, Zhejiang Province, China

    Xiao-Lei Chen

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  1. Wei-Zhe Chen
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  2. Qian-Tong Dong
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  3. Feng-Min Zhang
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  8. Xiao-Lei Chen
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Contributions

Study conception and design: X.L. Chen and Z. Yu. Acquisition of data: W.Z. Chen, Q.T. Dong and H.Y. Cai. Analysis and interpretation of data: F.M. Zhang, J.Y. Yan and C.L. Zhuang. Drafting of manuscript: W.Z. Chen and Q.T. Dong. Critical revision of manuscript: X.L. Chen.

Corresponding authors

Correspondence to Zhen Yu or Xiao-Lei Chen.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of The First Affiliated Hospital of Wenzhou Medical University and Tenth People’s Hospital Affiliated to TongJi University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Chen, WZ., Dong, QT., Zhang, FM. et al. Laparoscopic versus open resection for elderly patients with gastric cancer: a double-center study with propensity score matching method. Langenbecks Arch Surg 406, 449–461 (2021). https://doi.org/10.1007/s00423-020-01978-w

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