Advantages of Function-Preserving Gastrectomy for Older Patients With Upper-Third Early Gastric Cancer: Maintenance of Nutritional Status and Favorable Survival

Manabu Ohashi; Masayoshi Terayama; Satoshi Ida; Masaru Hayami; Rie Makuuchi; Koshi Kumagai; Takeshi Sano; Souya Nunobe

doi:10.5230/jgc.2023.23.e9

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자료유형: 학술저널

저자정보: Manabu Ohashi (Cancer Institute Hospital Japanese Foundation for Cancer Research) Masayoshi Terayama (Department of Gastroenterological Surgery Gastroenterological Center Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan) Satoshi Ida (Department of Gastroenterological Surgery Gastroenterological Center Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan) Masaru Hayami (Cancer Institute Hospital Japanese Foundation for Cancer Research) Rie Makuuchi (Cancer Institute Hospital Japanese Foundation for Cancer Research) Koshi Kumagai (Department of Gastroenterological Surgery Gastroenterological Center Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan) Takeshi Sano (Cancer Institute Hospital Japanese Foundation for Cancer Research) Souya Nunobe (Cancer Institute Hospital Japanese Foundation for Cancer Research)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제23권 제2호

발행연도: 2023.4

수록면: 303 - 314 (12page)

DOI: 10.5230/jgc.2023.23.e9

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Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic function-preserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into “LTG for LPG” (LTG-P) and “LTG for LSTG” (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions: LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival. Therefore, LFPG for upper early gastric cancer should be considered in older patients.

#Stomach neoplasms #Laparoscopy #Aged #Nutrition assessment #Skeletal muscle

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