Feasibility of laparoscopic radical gastric cancer surgery in super-elderly patients with locally advanced gastric cancer based on propensity score matching analysis
10.3969/j.issn.1009-9905.2024.12.007
- VernacularTitle:基于倾向性评分匹配分析腹腔镜胃癌根治术在超高龄局部进展期胃癌患者中的可行性
- Author:
Ming HOU
1
;
Cui-cui HUANG
;
Da-wei REN
Author Information
1. 山东大学齐鲁医院(青岛)健康管理中心(山东 青岛 266035)
- Publication Type:Journal Article
- Keywords:
Gastric cancer;
Laparoscopic surgery;
Super-elderly
- From:
Chinese Journal of Current Advances in General Surgery
2024;27(12):957-961
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the surgical and oncologic outcomes of laparoscopic ver-sus open gastrectomy in super-elderly patients with locally advanced gastric cancer(LAGC).Meth-ods:This retrospective cohort study was used to collect clinicopathological data of patients aged≥77 years with LAGC who underwent gastrectomy from January 2016 to December 2023.To bal-ance the differences between groups and reduce confounding bias,1∶1 propensity score matching(PSM)was performed by the nearest neighbor matching method with a caliper value of 0.05 set.Postoperative outcomes were compared between the two groups after PSM.Results:32 pa-tients were included in each group after PSM.Compared with the open group,the laparoscopic group had shorter incision lengths,less bleeding,lower VAS scores on POD2,earlier first time out of bed,shorter retention of abdominal drains,and shorter postoperative hospital stays,but-longer operative times.The overall complication rate was 31.3％and 46.9％in the laparoscopic and open groups,respectively;In subgroup analyses,the incidence of cardiopulmonary complica-tions(21.9％vs 31.3％)and severe complications(Clavien-Dindo grade≥Ⅲ,12.5％vs 18.8％)was lower in the laparoscopic group.The 3-year overall survival rates in the laparoscopic and opengroups were 66.7％and 62.5％(Log-rank P=0.812).The multivariateCox regression analysis identified age-adjusted Charlson comorbidity index＞6(HR 1.582,P=0.015)and TNM stage Ⅲ(HR 1.875,P=0.006)as independent risk factorsfor long-term survival.Conclusion:Compared to open procedure,laparoscopicgastrectomy is safe and feasible for super-elderly LAGC patients,with superior short-term outcomes and comparable survival outcomes.
