Survival after surgery for gastric cancer in patients over 70 years of age.
OBJECTIVE
The increase of the elderly population in western societies will result in a considerable increase of gastric cancer patients older than 70 years requiring surgery. However, higher postoperative morbidity and mortality rates after major surgery in the elderly are well recognized. The aim of this study was to evaluate the risk factors of mortality and predictors of survival in elderly patients with gastric cancer.


METHODS
We reviewed the data of the 165 patients evaluated for gastric cancer surgery in the Oulu University Hospital from January 1985 till December 1994 and made a computer analysis.


RESULTS
Postoperative mortality was 12% both after all laparotomies and after all resections, and 6% after radical resections. Mortality after radical resection did not associate significantly with any clinical variable but morbidity was associated with the number of coexistent diseases. The median and cumulative 5-year survivals after radical resections were 40 months and 38%. Survival was closely related to diagnostic delay, preoperative loss of weight, two or more coexistent disease, location of tumor, and recurrence in univariate analysis, but multivariate analysis showed only preoperative weight loss and recurrent disease to be independent predictors of survival.


CONCLUSIONS
Age alone is not a risk factor for postoperative mortality or a predictor of survival among elderly patients with gastric cancer. Early detection of malignancy and careful preoperative evaluation of the patients referred for resection are needed to improve survival.
Mäkelä
J T
JT
Oulu University Hospital, Department of Surgery, Finland. Jyrki.Makela@oulu.fi
Kiviniemi
H
H
Wiik
H
H
Laitinen
S
S
D000368:Aged; D005260:Female; D005387:Finland / Q000453:epidemiology; D005743:Gastrectomy; D006801:Humans; D008297:Male; D009017:Morbidity; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality* / Q000601:surgery; D016019:Survival Analysis