Comparison of gastric cancer surgery between patients aged >80 years and <79 years: complications and multivariate analysis of prognostic factors

Hepatogastroenterology. 2014 Sep;61(134):1785-93.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Chi-Square Distribution
  • Comorbidity
  • Female
  • Gastrectomy / adverse effects*
  • Gastrectomy / mortality
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Multivariate Analysis
  • Postoperative Complications / etiology*
  • Postoperative Complications / mortality
  • Postoperative Complications / therapy
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome