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The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes
Purpose It remains unclear whether laparoscopic gastrectomy (LG) for gastric cancer is a suitable treatment for very elderly (VE) patients. We aimed to assess the safety and feasibility of LG for gastric cancer in VE patients. Methods We reviewed 226 consecutive patients who underwent LG between Jan...
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| Published in: | Surgery today (Tokyo, Japan) Japan), 2021-02, Vol.51 (2), p.219-225 |
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| Main Authors: | , , , , , , , , , , , |
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| container_end_page | 225 |
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| container_title | Surgery today (Tokyo, Japan) |
| container_volume | 51 |
| creator | Mikami, Ryuichi Tanaka, Eiji Murakami, Teppei Ishida, Satoshi Matsui, Yugo Horita, Kenta Yamada, Masaki Nitta, Takashi Mise, Masahiro Harada, Takehisa Takeo, Masahiko Arii, Shigeki |
| description | Purpose
It remains unclear whether laparoscopic gastrectomy (LG) for gastric cancer is a suitable treatment for very elderly (VE) patients. We aimed to assess the safety and feasibility of LG for gastric cancer in VE patients.
Methods
We reviewed 226 consecutive patients who underwent LG between January 2010 and December 2016. We compared VE patients (age ≥ 80,
n
= 38) with non-elderly patients (age ≤ 79,
n
= 188).
Results
An ASA-PS score ≥ 2 was more common in VE group (86.8 vs. 48.9%;
P
|
| doi_str_mv | 10.1007/s00595-020-02078-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2425000588</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2425000588</sourcerecordid><originalsourceid>FETCH-LOGICAL-c371t-210cfe658575f3f937d5c5e2c7899a162e2cbdd1b78cd6616e3e6f2ba52abdaa3</originalsourceid><addsrcrecordid>eNp9kMtO3TAQhi1UBAfaF2BRecnGrS-x47BDCCgSUjd0bTnO-BCUxKntVMqOR68PoSy7GM3tn1-aD6ELRr8xSuvviVLZSEI5PUStSXWEdqwSinDNxCe0o03FCOMNO0VnKb1QyitN6Qk6FVzVSldqh16fngEn6yGv2E4d9mBT3_ZDX_rg8WBnG0NyYe4d3tuUI7gcxhX7ELe-zJ2dHETcT_gPxBXD0EEcVjzb3MOU0xVOzyFmcrAfwrQnGeKIw5JdGCF9RsfeDgm-vOdz9Ovu9unmB3n8ef9wc_1InKhZJpxR50FJLWvphW9E3UkngbtaN41lipey7TrW1tp1SjEFApTnrZXctp214hxdbr5zDL8XSNmMfXIwDHaCsCTDKy5pAap1kfJN6srrKYI3c-xHG1fDqDmQNxt5U6ibN_KmKkdf3_2XdoTu4-Qf6iIQmyCV1bSHaF7CEqfy8_9s_wJ105HF</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2425000588</pqid></control><display><type>article</type><title>The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes</title><source>Springer Nature</source><creator>Mikami, Ryuichi ; Tanaka, Eiji ; Murakami, Teppei ; Ishida, Satoshi ; Matsui, Yugo ; Horita, Kenta ; Yamada, Masaki ; Nitta, Takashi ; Mise, Masahiro ; Harada, Takehisa ; Takeo, Masahiko ; Arii, Shigeki</creator><creatorcontrib>Mikami, Ryuichi ; Tanaka, Eiji ; Murakami, Teppei ; Ishida, Satoshi ; Matsui, Yugo ; Horita, Kenta ; Yamada, Masaki ; Nitta, Takashi ; Mise, Masahiro ; Harada, Takehisa ; Takeo, Masahiko ; Arii, Shigeki</creatorcontrib><description>Purpose
It remains unclear whether laparoscopic gastrectomy (LG) for gastric cancer is a suitable treatment for very elderly (VE) patients. We aimed to assess the safety and feasibility of LG for gastric cancer in VE patients.
Methods
We reviewed 226 consecutive patients who underwent LG between January 2010 and December 2016. We compared VE patients (age ≥ 80,
n
= 38) with non-elderly patients (age ≤ 79,
n
= 188).
Results
An ASA-PS score ≥ 2 was more common in VE group (86.8 vs. 48.9%;
P
< 0.01). There were no significant differences in the operating time, blood loss, postoperative hospital stay, or postoperative morbidity between the groups. The 3-year survival rate and 3-year disease-specific survival rate were lower in the VE group (53.7 vs. 85.6%;
P
< 0.0001, 78.5 vs. 92.4%;
P
= 0.0116). A univariate analysis showed that PS scores ≥ 2, Charlson comorbidity index ≥ 4, and pN stage were independent predictors of decreased overall survival rates in the VE group. A multivariate analysis showed total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage to be independent predictors in the VE group.
Conclusion
LG for gastric cancer is, thus, considered to be safe for patients aged 80 years or older. Total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage were independent risk factors for a poor prognosis in these patients.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-020-02078-4</identifier><identifier>PMID: 32676846</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Medicine ; Medicine & Public Health ; Original Article ; Surgery ; Surgical Oncology</subject><ispartof>Surgery today (Tokyo, Japan), 2021-02, Vol.51 (2), p.219-225</ispartof><rights>Springer Nature Singapore Pte Ltd. 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-210cfe658575f3f937d5c5e2c7899a162e2cbdd1b78cd6616e3e6f2ba52abdaa3</citedby><cites>FETCH-LOGICAL-c371t-210cfe658575f3f937d5c5e2c7899a162e2cbdd1b78cd6616e3e6f2ba52abdaa3</cites><orcidid>0000-0002-0430-4939</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32676846$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mikami, Ryuichi</creatorcontrib><creatorcontrib>Tanaka, Eiji</creatorcontrib><creatorcontrib>Murakami, Teppei</creatorcontrib><creatorcontrib>Ishida, Satoshi</creatorcontrib><creatorcontrib>Matsui, Yugo</creatorcontrib><creatorcontrib>Horita, Kenta</creatorcontrib><creatorcontrib>Yamada, Masaki</creatorcontrib><creatorcontrib>Nitta, Takashi</creatorcontrib><creatorcontrib>Mise, Masahiro</creatorcontrib><creatorcontrib>Harada, Takehisa</creatorcontrib><creatorcontrib>Takeo, Masahiko</creatorcontrib><creatorcontrib>Arii, Shigeki</creatorcontrib><title>The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
It remains unclear whether laparoscopic gastrectomy (LG) for gastric cancer is a suitable treatment for very elderly (VE) patients. We aimed to assess the safety and feasibility of LG for gastric cancer in VE patients.
Methods
We reviewed 226 consecutive patients who underwent LG between January 2010 and December 2016. We compared VE patients (age ≥ 80,
n
= 38) with non-elderly patients (age ≤ 79,
n
= 188).
Results
An ASA-PS score ≥ 2 was more common in VE group (86.8 vs. 48.9%;
P
< 0.01). There were no significant differences in the operating time, blood loss, postoperative hospital stay, or postoperative morbidity between the groups. The 3-year survival rate and 3-year disease-specific survival rate were lower in the VE group (53.7 vs. 85.6%;
P
< 0.0001, 78.5 vs. 92.4%;
P
= 0.0116). A univariate analysis showed that PS scores ≥ 2, Charlson comorbidity index ≥ 4, and pN stage were independent predictors of decreased overall survival rates in the VE group. A multivariate analysis showed total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage to be independent predictors in the VE group.
Conclusion
LG for gastric cancer is, thus, considered to be safe for patients aged 80 years or older. Total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage were independent risk factors for a poor prognosis in these patients.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMtO3TAQhi1UBAfaF2BRecnGrS-x47BDCCgSUjd0bTnO-BCUxKntVMqOR68PoSy7GM3tn1-aD6ELRr8xSuvviVLZSEI5PUStSXWEdqwSinDNxCe0o03FCOMNO0VnKb1QyitN6Qk6FVzVSldqh16fngEn6yGv2E4d9mBT3_ZDX_rg8WBnG0NyYe4d3tuUI7gcxhX7ELe-zJ2dHETcT_gPxBXD0EEcVjzb3MOU0xVOzyFmcrAfwrQnGeKIw5JdGCF9RsfeDgm-vOdz9Ovu9unmB3n8ef9wc_1InKhZJpxR50FJLWvphW9E3UkngbtaN41lipey7TrW1tp1SjEFApTnrZXctp214hxdbr5zDL8XSNmMfXIwDHaCsCTDKy5pAap1kfJN6srrKYI3c-xHG1fDqDmQNxt5U6ibN_KmKkdf3_2XdoTu4-Qf6iIQmyCV1bSHaF7CEqfy8_9s_wJ105HF</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Mikami, Ryuichi</creator><creator>Tanaka, Eiji</creator><creator>Murakami, Teppei</creator><creator>Ishida, Satoshi</creator><creator>Matsui, Yugo</creator><creator>Horita, Kenta</creator><creator>Yamada, Masaki</creator><creator>Nitta, Takashi</creator><creator>Mise, Masahiro</creator><creator>Harada, Takehisa</creator><creator>Takeo, Masahiko</creator><creator>Arii, Shigeki</creator><general>Springer Singapore</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0430-4939</orcidid></search><sort><creationdate>20210201</creationdate><title>The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes</title><author>Mikami, Ryuichi ; Tanaka, Eiji ; Murakami, Teppei ; Ishida, Satoshi ; Matsui, Yugo ; Horita, Kenta ; Yamada, Masaki ; Nitta, Takashi ; Mise, Masahiro ; Harada, Takehisa ; Takeo, Masahiko ; Arii, Shigeki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-210cfe658575f3f937d5c5e2c7899a162e2cbdd1b78cd6616e3e6f2ba52abdaa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mikami, Ryuichi</creatorcontrib><creatorcontrib>Tanaka, Eiji</creatorcontrib><creatorcontrib>Murakami, Teppei</creatorcontrib><creatorcontrib>Ishida, Satoshi</creatorcontrib><creatorcontrib>Matsui, Yugo</creatorcontrib><creatorcontrib>Horita, Kenta</creatorcontrib><creatorcontrib>Yamada, Masaki</creatorcontrib><creatorcontrib>Nitta, Takashi</creatorcontrib><creatorcontrib>Mise, Masahiro</creatorcontrib><creatorcontrib>Harada, Takehisa</creatorcontrib><creatorcontrib>Takeo, Masahiko</creatorcontrib><creatorcontrib>Arii, Shigeki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mikami, Ryuichi</au><au>Tanaka, Eiji</au><au>Murakami, Teppei</au><au>Ishida, Satoshi</au><au>Matsui, Yugo</au><au>Horita, Kenta</au><au>Yamada, Masaki</au><au>Nitta, Takashi</au><au>Mise, Masahiro</au><au>Harada, Takehisa</au><au>Takeo, Masahiko</au><au>Arii, Shigeki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>51</volume><issue>2</issue><spage>219</spage><epage>225</epage><pages>219-225</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
It remains unclear whether laparoscopic gastrectomy (LG) for gastric cancer is a suitable treatment for very elderly (VE) patients. We aimed to assess the safety and feasibility of LG for gastric cancer in VE patients.
Methods
We reviewed 226 consecutive patients who underwent LG between January 2010 and December 2016. We compared VE patients (age ≥ 80,
n
= 38) with non-elderly patients (age ≤ 79,
n
= 188).
Results
An ASA-PS score ≥ 2 was more common in VE group (86.8 vs. 48.9%;
P
< 0.01). There were no significant differences in the operating time, blood loss, postoperative hospital stay, or postoperative morbidity between the groups. The 3-year survival rate and 3-year disease-specific survival rate were lower in the VE group (53.7 vs. 85.6%;
P
< 0.0001, 78.5 vs. 92.4%;
P
= 0.0116). A univariate analysis showed that PS scores ≥ 2, Charlson comorbidity index ≥ 4, and pN stage were independent predictors of decreased overall survival rates in the VE group. A multivariate analysis showed total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage to be independent predictors in the VE group.
Conclusion
LG for gastric cancer is, thus, considered to be safe for patients aged 80 years or older. Total gastrectomy, a Charlson comorbidity index ≥ 4, and the pN stage were independent risk factors for a poor prognosis in these patients.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>32676846</pmid><doi>10.1007/s00595-020-02078-4</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0430-4939</orcidid></addata></record> |
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| source | Springer Nature |
| subjects | Medicine Medicine & Public Health Original Article Surgery Surgical Oncology |
| title | The safety and feasibility of laparoscopic gastrectomy for gastric cancer in very elderly patients: short-and long-term outcomes |
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