BACKGROUND Compared with open standard gastrectomy (OG), laparoscopic gastrectomy (LG) did not result in inferior disease-free survival for early-stage and locally advanced gastric cancer (AGC). However, whether LG for AGC in elderly patients is more beneficial than OG is unclear. METHODS This study examined 458 patients with AGC. The mortality, morbidity, and prognosis were compared by age, gender, T and N factors, and pathological stage in the LG and OG groups using propensity score matching analysis. For the final analysis, 151 pairs of patients were selected from at each group. RESULTS The results showed that no significant difference in mortality and morbidity existed between the two groups. The 5-year relapse-free survival (RFS) rates were 70% and 62% in the LG and OG groups, respectively (p = 0.104). The 5-year RFS rates in patients with pathological stages I, II, and III who had undergone LG were 84%, 80%, and 55%, respectively, and 78%, 70%, and 45%, respectively, in those who had undergone OG (p < 0.005). The 5-year RFS rates in nonelderly patients who underwent LG or OG were 75% and 68%, respectively, and 58% and 40%, respectively, in elderly patients who underwent LG or OG (p < 0.005). CONCLUSION The 5-year RFS rates in patients with AGC at each stage did not significantly differ between LG and OG. However, the benefits at 5-year RFS in patients who underwent LG compared with OG were larger in elderly patients than those in nonelderly patients.

中文翻译：

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单院腹腔镜手术与开放标准手术治疗晚期胃癌的比较：倾向评分匹配分析。

背景与开放标准胃切除术（OG）相比，腹腔镜胃切除术（LG）并未导致早期和局部晚期胃癌（AGC）的无病生存率降低。然而，对于老年患者的 AGC，LG 是否比 OG 更有益尚不清楚。方法 本研究检查了 458 名 AGC 患者。采用倾向评分匹配分析，比较LG组和OG组的年龄、性别、T和N因素、病理分期的死亡率、发病率和预后。对于最终分析，从每组中选择151对患者。结果结果显示，两组的病死率和发病率无显着差异。LG 组和 OG 组的 5 年无复发生存率 (RFS) 分别为 70% 和 62% (p = 0.104)。病理分期 I、II 和 III 的患者接受 LG 的 5 年 RFS 率分别为 84%、80% 和 55%，而接受 LG 的患者的 5 年 RFS 率分别为 78%、70% 和 45%。经历了 OG (p < 0.005)。接受 LG 或 OG 的非老年患者的 5 年 RFS 率分别为 75% 和 68%，而接受 LG 或 OG 的老年患者的 5 年 RFS 率分别为 58% 和 40% (p < 0.005)。结论 LG 和 OG 各阶段 AGC 患者的 5 年 RFS 率无显着差异。然而，与 OG 相比，接受 LG 的患者 5 年 RFS 的益处在老年患者中大于非老年患者。接受 LG 或 OG 的非老年患者的 5 年 RFS 率分别为 75% 和 68%，而接受 LG 或 OG 的老年患者的 5 年 RFS 率分别为 58% 和 40% (p < 0.005)。结论 LG 和 OG 各阶段 AGC 患者的 5 年 RFS 率没有显着差异。然而，与 OG 相比，接受 LG 的患者 5 年 RFS 的益处在老年患者中大于非老年患者。接受 LG 或 OG 的非老年患者的 5 年 RFS 率分别为 75% 和 68%，而接受 LG 或 OG 的老年患者的 5 年 RFS 率分别为 58% 和 40% (p < 0.005)。结论 LG 和 OG 各阶段 AGC 患者的 5 年 RFS 率无显着差异。然而，与 OG 相比，接受 LG 的患者 5 年 RFS 的益处在老年患者中大于非老年患者。