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  • Title: Comparison of gastric cancer surgery between patients aged >80 years and <79 years: complications and multivariate analysis of prognostic factors.
    Author: Fujiwara Y, Tsujie M, Hara J, Kato H, Kitani K, Isono S, Takeyama H, Yukawa M, Inoue M, Kanaizumi H.
    Journal: Hepatogastroenterology; 2014 Sep; 61(134):1785-93. PubMed ID: 25436380.
    Abstract:
    BACKGROUND/AIMS: To evaluate the clinicopathological features and results of surgery for gastric cancer in elderly patients aged ˃80 years relative to those aged ˂79 years, and to recommend the appropriate surgical treatment for elderly patients. METHODOLOGY: A total of 332 patients with gastric cancer who underwent gastrectomy in our department between 2002 and 2012 were evaluated. Of these, 81 were aged ˃80 years (Group A) and 251 were aged ˂79 years (Group B). We compared surgical outcomes and survival in these two groups. RESULTS; Postopeartive complications were associated with preoperative cormorbid disease(p<0.01). D2 and R0 resection was common in GroupB (p<0.01). Respiratory complications and hospital deaths were higher in Group A than in Group B. Overall survival (OS) was significantly lower in Group A than in Group B. Regarding Stage I disease, OS was significantly lower in Group A; however, cause-specific survival was similar between the two groups. Multivariate analysis showed that radicality and postoperative complications were independent prognostic factors for OS in elderly gastric cancer patients. CONCLUSIONS: These results indicate that postoperative respiratory complications and other causes of death worsened the prognosis of elderly. Preoperative accurate judgment of co-morbid disease, meticulous postoperative management and follow up might be improved survival of gastric cancer in elderly.
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