Gastric cancer surgery in patients aged at least 80 years old.
Fifty-six patients with gastric cancer who were at least 80 years of age (range 80-88) (Group 1) were retrospectively investigated and compared with younger patients. The resectability rate was 80% (45/56) in Group 1, 88% (331/373) in Group 2 (patients aged between 70 and 79) and 91% (992/1,087) in Group 3 (patients aged under 70 years). Of the cases resected, 73% had advanced cancer in Group 1, 61% in Group 2 and 55% in Group 3. Total gastrectomy was performed in only 11% of the resected cases in Group 1, in 25% of those in Group 2 and in 33% in Group 3. Of these, combined resections were employed in none of the patients in Group 1, in 38% of those in Group 2 and in 47% of those in Group 3. Pathologically, 78% of Group 1 cancers were of the differentiated type, 68% of Group 2 and 49% of Group 3 cancers (Group 1: Group 3, p < 0.001). R3 gastrectomy was performed for advanced cancer in none of the patients in Group 1, in 21% in Group 2, and in 39% of those in Group 3. In resected early cancers, the lymph node metastasis (n) rate was 0% for Group 1, 10% for Group 2, and 9% for Group 3. In the advanced cases, n(+) was 67% for Group 1, 65% for Group 2, and 73% for Group 3. Postoperative complications occurred in 25% of Group 1 and in 12% of Group 2 patients. Anastomotic leakage occurred in 4% of Group 1 and in 5% of Group 2 patients. The 5-year-survival rate was 47% for all resected cases in Group 1, and 68% for Groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)
Takeda
J
J
First Department of Surgery, Kurume University School of Medicine, Japan.
Tanaka
T
T
Koufuji
K
K
Kodama
I
I
Tsuji
Y
Y
Kakegawa
T
T
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome