J Gastric Cancer.  2018 Jun;18(2):109-117. 10.5230/jgc.2018.18.e11.

Role of Laparoscopic Gastrectomy in Very Elderly Patients with Gastric Cancer Who Have Outlived the Average Lifespan

• Kim DJ
• Kim W

• KMID: 2414531
• DOI: http://doi.org/10.5230/jgc.2018.18.e11

Abstract

PURPOSE
This study aimed to investigate the outcomes of laparoscopic gastrectomy in very elderly patients with gastric cancer, who have outlived the average lifespan of the Korean population (men: ≥77 years, women: ≥84 years).
MATERIALS AND METHODS
Between 2004 and 2015, 836 patients with gastric cancer underwent a laparoscopic gastrectomy. They were divided into the elderly group (EldG) and non-elderly group (nEldG). Propensity score matching for covariates of sex, tumor depth, node status, and extent of resection was performed. Clinicopathologic characteristics, and surgical and survival outcomes were compared between the 2 groups.
RESULTS
The EldG had a higher American Society of Anesthesiologists (ASA) score and a higher number of comorbidities. There was no significant difference in the post-operative complications, except for pulmonary complications, which were more frequent in the EldG (5/56, 8.9%) than in the nEldG (0/56, 0%). The EldG had a shorter overall survival (OS), but cancer-specific survival was similar for both groups. Among deceased patients, 2 (25%) and 8 patients (50%) died within a year of surgery in the nEldG and EldG, respectively. Univariate and multivariate risk factor analyses for OS showed that age, ASA score, tumor, node, metastasis (TNM) stage, and occurrence of complications were significantly related to deterioration in OS.
CONCLUSIONS
Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended.

Keyword

Stomach neoplasms; Laparoscopy; Elderly

MeSH Terms

Aged*
Comorbidity
Female
Gastrectomy*
Humans
Laparoscopy
Neoplasm Metastasis
Patient Selection
Propensity Score
Risk Factors
Stomach Neoplasms*

Figure

• 

  Fig. 1 Survival analysis between the EldG and nEldG: (A) OS, (B) cancer-specific survival. EldG = elderly group; nEldG = non-elderly group; OS = overall survival.

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