Laparoscopy-assisted Distal Gastrectomy for Gastric Cancer in Elderly Patients: Surgical Outcomes and Prognosis.

BACKGROUND/AIM Elderly patients usually have various comorbidities. Laparoscopic gastrectomy as a minimally-invasive treatment might be feasible for these patients. The aim of this study was to evaluate the safety and efficacy of laparoscopy-assisted distal gastrectomy (LADG) in elderly patients with gastric cancer by comparing the surgical outcomes and prognosis. PATIENTS AND METHODS We analyzed 136 patients who had undergone LADG between January 2013 and December 2014. We compared elderly patients (75 years old or more) with non-elderly patients. RESULTS The incidence of all postoperative complications did not differ between groups, and there were no significant differences in the time to first oral intake or the duration of postoperative hospital stay. The 3-year overall and recurrence-free survival rates were not significantly different between the groups. CONCLUSION LADG is a safe and less invasive treatment for gastric cancer in elderly patients, who have a greater incidence of comorbidity.

[1]  T. Yoshikawa,et al.  Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912 , 2017, Gastric Cancer.

[2]  J. Ji,et al.  Feasibility of laparoscopic gastrectomy for elderly gastric cancer patients: meta-analysis of non-randomized controlled studies , 2017, Oncotarget.

[3]  Lijun Zheng,et al.  Laparoscopy-assisted versus open distal gastrectomy for gastric cancer in elderly patients: a retrospective comparative study , 2016, Surgical Endoscopy.

[4]  Japanese Gastric Cancer Association Japanese gastric cancer treatment guidelines 2014 (ver. 4) , 2016, Gastric Cancer.

[5]  Go Anegawa,et al.  Laparoscopy-assisted distal gastrectomy for early gastric cancer poses few limitations for selected elderly patients: a single-center experience , 2016, Surgical Case Reports.

[6]  J. Yamamoto,et al.  Efficacy of totally laparoscopic distal gastrectomy for gastric cancer in elderly patients. , 2016, Molecular and clinical oncology.

[7]  K. Yanaga,et al.  Laparoscopic gastrectomy for gastric cancer in the elderly patients , 2016, Surgical Endoscopy.

[8]  Neng-yun Zhang,et al.  Laparoscopic gastrectomy versus open gastrectomy for elderly patients with gastric cancer: a systematic review and meta-analysis , 2016, World Journal of Surgical Oncology.

[9]  C. Mathers,et al.  Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012 , 2015, International journal of cancer.

[10]  P. Jacobsen,et al.  Geriatric oncology: an overview. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  W. Xu,et al.  Laparoscopic radical gastrectomy versus traditional open surgery in elderly patients with gastric cancer: Benefits and complications. , 2014, Molecular and clinical oncology.

[12]  N. Hatanaka,et al.  Prognosis of gastric carcinoma patients aged 85 years or older who underwent surgery or who received best supportive care only , 2013, International Journal of Clinical Oncology.

[13]  B. Kim,et al.  The impact of old age on surgical outcomes of totally laparoscopic gastrectomy for gastric cancer , 2013, Surgical Endoscopy.

[14]  Y. Yun,et al.  Long-term outcomes of laparoscopy-assisted distal gastrectomy for early gastric cancer: result of a randomized controlled trial (COACT 0301) , 2013, Surgical Endoscopy.

[15]  Hyuk-Joon Lee,et al.  Minimally invasive approaches for gastric cancer—Korean experience , 2013, Journal of surgical oncology.

[16]  Masafumi Inomata,et al.  Minimally invasive approaches for gastric cancer—Japanese experiences , 2013, Journal of surgical oncology.

[17]  K. Seo,et al.  Laparoscopy-Assisted Distal Gastrectomy for Early Gastric Cancer in the Elderly , 2012, Journal of gastric cancer.

[18]  L. Cai,et al.  Laparoscopy-Assisted Versus Open Distal Gastrectomy for Early Gastric Cancer: Evidence from Randomized and Nonrandomized Clinical Trials , 2012, Annals of surgery.

[19]  D. Park,et al.  Comparison of complications after laparoscopy-assisted distal gastrectomy and open distal gastrectomy for gastric cancer using the Clavien–Dindo classification , 2012, Surgical Endoscopy.

[20]  Zongguang Zhou,et al.  Spread and development of laparoscopic surgery for gastric tumors in mainland China: initial experiences. , 2012, Hepato-gastroenterology.

[21]  K. Kojima,et al.  Laparoscopy-assisted gastrectomy in patients older than 80. , 2010, The Journal of surgical research.

[22]  S. Ryu,et al.  Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly , 2009, The British journal of surgery.

[23]  Xin-Zu Chen,et al.  Short-term Evaluation of Laparoscopy-assisted Distal Gastrectomy for Predictive Early Gastric Cancer: A Meta-analysis of Randomized Controlled Trials , 2009, Surgical laparoscopy, endoscopy & percutaneous techniques.

[24]  H. Shimada,et al.  Efficacy of laparoscopy-assisted distal gastrectomy for gastric cancer in the elderly , 2009, Surgical Endoscopy.

[25]  Shahjahan Khan,et al.  Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma , 2008, Surgical Endoscopy.

[26]  Norio Shiraishi,et al.  A Multicenter Study on Oncologic Outcome of Laparoscopic Gastrectomy for Early Cancer in Japan , 2007, Annals of surgery.

[27]  Florence E. Turrentine,et al.  Surgical risk factors, morbidity, and mortality in elderly patients. , 2006, Journal of the American College of Surgeons.

[28]  M. Memon,et al.  Laparoscopic surgery in the elderly patient , 2003, Surgical Endoscopy And Other Interventional Techniques.

[29]  J. A. Fernández-Represa,et al.  Complications of laparoscopic cholecystectomy in the ageing patient. , 1997, Age and ageing.

[30]  Meyer Saklad,et al.  GRADING OF PATIENTS FOR SURGICAL PROCEDURES , 1941 .

[31]  D. Park,et al.  Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared With Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes From a Multicenter Randomized Controlled Trial (KLASS-01). , 2016, Annals of surgery.

[32]  PhD Satoshi Suzuki MD,et al.  Carbon Dioxide Pneumoperitoneum Led to No Severe Morbidities for the Elderly During Laparoscopic-Assisted Distal Gastrectomy , 2014, Annals of Surgical Oncology.

[33]  Japanese Gastric Cancer Association Japanese classification of gastric carcinoma: 3rd English edition , 2011, Gastric Cancer.

[34]  N. Katada,et al.  Laparoscopy-assisted distal gastrectomy for early gastric cancer , 2005, Surgical Endoscopy And Other Interventional Techniques.

[35]  S. Kitano,et al.  A randomized controlled trial comparing open vs laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer: an interim report. , 2002, Surgery.