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Comparison of laparoscopic surgery with open standard surgery for advanced gastric carcinoma in a single institute: a propensity score matching analysis

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Abstract

Background

Compared with open standard gastrectomy (OG), laparoscopic gastrectomy (LG) did not result in inferior disease-free survival for early-stage and locally advanced gastric cancer (AGC). However, whether LG for AGC in elderly patients is more beneficial than OG is unclear.

Methods

This study examined 458 patients with AGC. The mortality, morbidity, and prognosis were compared by age, gender, T and N factors, and pathological stage in the LG and OG groups using propensity score matching analysis. For the final analysis, 151 pairs of patients were selected from at each group.

Results

The results showed that no significant difference in mortality and morbidity existed between the two groups. The 5-year relapse-free survival (RFS) rates were 70% and 62% in the LG and OG groups, respectively (p = 0.104). The 5-year RFS rates in patients with pathological stages I, II, and III who had undergone LG were 84%, 80%, and 55%, respectively, and 78%, 70%, and 45%, respectively, in those who had undergone OG (p < 0.005). The 5-year RFS rates in nonelderly patients who underwent LG or OG were 75% and 68%, respectively, and 58% and 40%, respectively, in elderly patients who underwent LG or OG (p < 0.005).

Conclusion

The 5-year RFS rates in patients with AGC at each stage did not significantly differ between LG and OG. However, the benefits at 5-year RFS in patients who underwent LG compared with OG were larger in elderly patients than those in nonelderly patients.

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Acknowledgements

This work was supported, in part, by a Grant-in-Aid from the Ministry of Education, Culture, Sport, Science and Technology of Japan (Grant No. 16K10525).

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Authors and Affiliations

  1. Department of Surgery, Fukuoka Sanno Hospital, 3-6-45 Momochi-hama, Sawara-ku, Fukuoka, 814-0001, Japan

    Manabu Yamamoto

  2. Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan

    Manabu Yamamoto, Mitsuhiko Ohta, Hideo Uehara, Masahiko Sugiyama, Yuichiro Nakashima, Tomonori Nakanoko, Masahiko Ikebe, Yuki Shin, Keiichi Shiokawa, Masaru Morita & Yasushi Toh

  3. Department of Biostatistics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan

    Mototsugu Shimokawa

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Correspondence to Manabu Yamamoto.

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Manabu Yamamoto, Mototsugu Shimokawa, Mitsuhiko Ohta, Hideo Uehara, Masahiko Sugiyama, Yuichiro Nakashima, Tomonori Nakanoko, Yuki Shin, Keiichi Shiokawa, Masaru Morita, and Yasushi Toh have no conflict of interest or financial ties to disclose.

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Yamamoto, M., Shimokawa, M., Ohta, M. et al. Comparison of laparoscopic surgery with open standard surgery for advanced gastric carcinoma in a single institute: a propensity score matching analysis. Surg Endosc 36, 3356–3364 (2022). https://doi.org/10.1007/s00464-021-08652-2

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