Laparoscopic versus open gastrectomy for gastric carcinoma in elderly patients: a pair-matched study

The safety of laparoscopic gastrectomy in elderly patients with gastric carcinoma has not been demonstrated. The aim of this study was to compare the outcomes of laparoscopic and open gastrectomy and estimate the feasibility of laparoscopic gastrectomy in gastric carcinoma patients aged ≥70 years. We conducted a retrospective pair-matched study of gastric carcinoma patients aged ≥70 years between January 2008 and January 2015. A total of 128 gastric carcinoma patients (64 pairs) underwent radical resection and were included in this analysis. The primary end point was 5-year overall survival. Secondary end points included disease-free survival and shortterm outcomes. No significant differences were observed in baseline data between the laparoscopy group and open group. Overall survival and disease-free survival did not differ between the two groups (P = 0.335 and 0.239, respectively). Laparoscopic gastrectomy was associated with less blood loss, faster recovery and shorter hospital stay than was open gastrectomy. Laparoscopic gastrectomy was not found to be a significant predictor for overall survival and disease-free survival by univariate and multivariate analysis. In summary, laparoscopic gastrectomy is an acceptable alternative to open gastrectomy in elderly patients with operable gastric carcinoma.