title: Impact of age on postoperative outcomes in 1118 gastric cancer patients undergoing surgical treatment.
abstract: BACKGROUND
  The purpose of the study was to evaluate the impact of age on outcomes in gastric cancer surgery.
  
  
  METHODS
  Patients on the hospital database who underwent gastric resection for gastric cancer during the period 1990-2005 (n = 1118) were divided into two groups: group A, patients 75 years or older (n = 249), and group B, those younger than 75 years (n = 869).
  
  
  RESULTS
  Overall preoperative complications were diagnosed in 92 (37%) patients of group A, compared with 147 (17%) in group B (P = 0.002). Fifty-five percent of patients underwent resection with D2 or more lymph node dissection (37% [n = 93] in group A, and 60% [n = 521] in group B; P = 0.003). Postoperative overall morbidity was higher in the elderly group (29% in group A versus 23% in group B), but the difference between the two groups was not significant (P = NS). Overall postoperative surgical complications were recorded in 201 (18%) patients; 49 (20%) in the elderly cohort, compared with 147 (17%) in the younger group (P = NS). The postoperative mortality rate was 3% (n = 7) in the elderly group, compared with 3% (n = 26) in the younger cohort (P = NS). Multivariate Cox analysis showed that age was not an independent risk factor for postoperative morbidity and mortality. Overall 5-year survival was 47% in group A and 54% in group B (P = NS).
  
  
  CONCLUSIONS
  Due to improved perioperative management, resection of gastric carcinoma is the treatment of choice in elderly patients. Although comorbidities were more frequent among the elderly patients, postoperative morbidity and mortality, even after extensive resections, was low. Survival rates were comparable to those in the younger patients.
authors.affiliation: Chirurgia gastroenterologica, Department of Surgery, University Vita-Salute, San Raffaele Scientific Institute, Via Olgettina, 60-20132, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Orsenigo
authors.forename: Valentina
authors.initials: V
authors.lastname: Tomajer
authors.forename: Saverio Di
authors.initials: SD
authors.lastname: Palo
authors.forename: Michele
authors.initials: M
authors.lastname: Carlucci
authors.forename: Andrea
authors.initials: A
authors.lastname: Vignali
authors.forename: Andrea
authors.initials: A
authors.lastname: Tamburini
authors.forename: Carlo
authors.initials: C
authors.lastname: Staudacher
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis