Is Laparoscopic Gastrectomy More Advantageous for Elderly Patients Than for Young Patients with Resectable Advanced Gastric Cancer?

Ushimaru, Yuki; Kurokawa, Yukinori; Takahashi, Tsuyoshi; Saito, Takuro; Yamashita, Kotaro; Makino, Tomoki; Yamasaki, Makoto; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro

doi:10.1007/s00268-020-05486-2

Cited by 19 publications

(12 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Shimada et al showed that although 5-year OS was signi cant lower in the elderly group than in the non-elderly group, 5-year DSS was similar in the two groups, as with our results [30]. Ushimaru et al reported that although DSS was similar between the laparoscopic and open groups among young and elderly patients, the laparoscopic group was associated with more favorable OS than the open group only among the elderly patients because of the lower number of deaths from respiratory diseases [31]. Some reports indicated that the incidence of postoperative complications was an important factor that in uenced long-term outcomes [24,[32][33][34]].…”

Section: Discussionsupporting

confidence: 88%

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥80 years old

Ueda

Shiraishi

Fujishima

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: As the incidence of gastric cancer increases in elderly patients worldwide, laparoscopic gastrectomy (LG) for elderly patients with gastric cancer is also increasing. However, whether LG is an optimal surgical modality for elderly patients with gastric cancer remains unclear. This study aimed to evaluate the technical and oncological safety of LG for elderly patients ≥80 years old with gastric cancer.Methods: Patients who received curative gastrectomy for gastric cancer from 2003 to 2015 were enrolled in the study. They were divided into the LG in elderly patients aged over 80 years (LG-E) group, open gastrectomy (OG) in elderly patients (OG-E) group, and LG in non-elderly patients < 80 years (LG-NE) group. Short- and long-term outcomes were compared between the three groups, retrospectively.Results: The LG-E, OG-E, and LG-NE groups comprised 45, 43, and 329 patients, respectively. In the comparison between the LG-E and OG-E groups, the incidence of distal gastrectomy (DG) and the proportions of patients with pathological tumor stage T1, pathological N0, and final stage I were significantly higher in the LG-E versus OG-E group (89 vs. 56%, 76% vs. 16%, 82% vs. 37%, and 84% vs. 35%, p<0.01, respectively). Blood loss and the incidence of overall postoperative complications in the LG-E group were significantly lower than those in the OG-E group (40 vs. 240 g, p<0.01, and 29% vs. 53%, p<0.05, respectively). Although the 5-year overall survival (OS) rate was not significantly different between the two groups, the 5-year disease-specific survival (DSS) rate was significantly higher in the LG-E group versus OG-E group (93% vs. 78%, p<0.05). Overall comorbidities were significantly higher in the LG-E group versus LG-NE group, but there were no significant differences in short-term outcomes between the two groups. Further, although the 5-year OS rate was significantly lower in the LG-E group versus LG-NE group (67% vs. 87%, p<0.01), there was no significant difference between the two groups in 5-year DSS rate.Conclusion: LG is technically and oncologically safe for the treatment of gastric cancer in both elderly patients aged ≥80 years and the non-elderly and can be an optimal surgical modality for elderly patients with gastric cancer.

show abstract

Section: Discussionsupporting

confidence: 88%

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥80 years old

Ueda

Shiraishi

Fujishima

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A previous study by our group indicated the potential benefits of laparoscopic gastrectomy for elderly patients with resectable GC [20]. Ushimaru et al [21] reported that laparoscopic gastrectomy might improve the OS by reducing mortality from respiratory diseases. Still, the benefit of adjuvant chemotherapy after laparoscopic D2 gastrectomy in elderly patients is unknown.…”

Section: Introductionmentioning

confidence: 89%

Survival analysis of elderly patients over 65 years old with stage II/III gastric cancer treated with adjuvant chemotherapy after laparoscopic D2 gastrectomy: a retrospective cohort study

et al. 2021

View full text Add to dashboard Cite

Background The benefits of adjuvant chemotherapy for elderly patients with gastric cancer (GC) remain unknown because elderly patients are underrepresented in most clinical trials. This study aimed to evaluate the effectiveness and complications of adjuvant chemotherapy in patients > 65 years of age after laparoscopic D2 gastrectomy. Methods This was a single-center retrospective cohort study of elderly patients (> 65 years) with stage II/III GC who underwent curative laparoscopic D2 gastrectomy with R0 resection between 2004 and 2018. The adjuvant chemotherapy regimens included monotherapy (oral capecitabine) and doublet chemotherapy (oral capecitabine plus intravenous oxaliplatin [XELOX] or intravenous oxaliplatin, leucovorin, and 5-fluorouracil [FOLFOX]). The data were retrieved from a prospectively registered database maintained at the Department of General Surgery in Nanfang Hospital, China. The patients were divided as surgery alone and surgery plus adjuvant chemotherapy (chemo group). The overall survival (OS), disease-free survival (DFS), chemotherapy duration, and toxicity were examined. Results There were 270 patients included: 169 and 101 in the surgery and chemo groups, respectively. There were 10 (10/101) and six (6/101) patients with grade 3+ non-hematological and hematological adverse events. The 1−/3−/5-year OS rates of the surgery group were 72.9%/51.8%/48.3%, compared with 90.1%/66.4%/48.6% for the chemo group (log-rank test: P = 0.018). For stage III patients, the 1−/3−/5-year OS rates of the surgery group were 83.7%/40.7%/28.7%, compared with 89.9%/61.2%/43.6% for the chemo group (log-rank test: P = 0.015). Adjuvant chemotherapy was significantly associated with higher OS (HR = 0.568, 95%CI: 0.357–0.903, P = 0.017) and DFS (HR = 0.511, 95%CI: 0.322–0.811, P = 0.004) in stage III patients. Conclusions This study suggested that adjuvant chemotherapy significantly improves OS and DFS compared with surgery alone in elderly patients with stage III GC after D2 laparoscopic gastrectomy, with a tolerable adverse event profile.

show abstract

“…Shimada et al showed that although 5-year OS was significant lower in the elderly group than in the non-elderly group, 5-year DSS was similar in the two groups, as with our results [ 30 ]. Ushimaru et al reported that although DSS was similar between the laparoscopic and open groups among young and elderly patients, the laparoscopic group was associated with more favorable OS than the open group only among the elderly patients because of the lower number of deaths from respiratory diseases [ 31 ]. Some reports indicated that the incidence of postoperative complications was an important factor that influenced long-term outcomes [ 24 , 32 – 34 ].…”

Section: Discussionmentioning

confidence: 99%

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥ 80 years old

et al. 2022

View full text Add to dashboard Cite

Background As the incidence of gastric cancer increases in elderly patients worldwide, laparoscopic gastrectomy (LG) for elderly patients with gastric cancer is also increasing. However, whether LG is an optimal surgical modality for elderly patients with gastric cancer remains unclear. This study aimed to evaluate the technical and oncological safety of LG for elderly patients ≥ 80 years old with gastric cancer. Methods Patients who received curative gastrectomy for gastric cancer from 2003 to 2015 were enrolled in the study. They were divided into the LG in elderly patients aged over 80 years (LG-E) group, open gastrectomy (OG) in elderly patients (OG-E) group, and LG in non-elderly patients < 80 years (LG-NE) group. Patients’ demographics and short- and long-term outcomes, such as postoperative complications and 5-year survival rate, were compared between the three groups, retrospectively. Results The LG-E, OG-E, and LG-NE groups comprised 45, 43, and 329 patients, respectively. In the comparison between the LG-E and OG-E groups, the incidence of distal gastrectomy (DG) and the proportions of patients with pathological tumor stage T1, pathological N0, and final stage I were significantly higher in the LG-E versus OG-E group (89 vs. 56%, 76% vs. 16%, 82% vs. 37%, and 84% vs. 35%, p < 0.01, respectively). Blood loss and the incidence of overall postoperative complications in the LG-E group were significantly lower than those in the OG-E group (40 vs. 240 g, p < 0.01, and 29% vs. 53%, p < 0.05, respectively). Although the 5-year overall survival (OS) rate was not significantly different between the two groups, the 5-year disease-specific survival (DSS) rate was significantly higher in the LG-E group versus OG-E group (93% vs. 78%, p < 0.05). Overall comorbidities were significantly higher in the LG-E group versus LG-NE group, but there were no significant differences in short-term outcomes between the two groups. Further, although the 5-year OS rate was significantly lower in the LG-E group versus LG-NE group (67% vs. 87%, p < 0.01), there was no significant difference between the two groups in 5-year DSS rate. Conclusion LG is technically and oncologically safe for the treatment of gastric cancer in both elderly patients aged ≥ 80 years and the non-elderly and can be an optimal surgical modality for elderly patients with gastric cancer.

show abstract

Is Laparoscopic Gastrectomy More Advantageous for Elderly Patients Than for Young Patients with Resectable Advanced Gastric Cancer?

Cited by 19 publications

References 47 publications

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥80 years old

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥80 years old

Survival analysis of elderly patients over 65 years old with stage II/III gastric cancer treated with adjuvant chemotherapy after laparoscopic D2 gastrectomy: a retrospective cohort study

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥ 80 years old

Contact Info

Product

Resources

About