title: Treatment for gastric carcinoma in the oldest old patients.
abstract: BACKGROUND
  The strategy for treating extremely aged patients with gastric carcinoma is controversial. This study reviews the prognoses of patients aged 85 years and older who were diagnosed with gastric carcinoma.
  
  
  METHODS
  One hundred seventeen patients aged 85 years and older were diagnosed as having gastric carcinoma after 1969 in our institution. After excluding those at stage IV, 36 cases underwent curative resection and 30 cases received best supportive care (BSC), which we reviewed retrospectively.
  
  
  RESULTS
  Surgical methods included distal gastrectomy for 28 cases, total gastrectomy for five cases, and other procedures for three cases. Postoperatively, pneumonia developed in four cases, anastomotic leakage in two cases, and pancreatic fistula in one case. Two patients died of pneumonia within 1 month of surgery. Univariate analysis demonstrated that age, surgery, performance status, and sodium level were statistically significant prognostic factors. Multivariate analysis demonstrated that surgery was the only independent prognostic factor. When patients with a performance status of 4 were excluded, the clinical characteristics of the surgery group (n = 36) and BSC group (n = 20) were statistically identical, and the overall survival was significantly better in the surgery group (p = 0.0078).
  
  
  CONCLUSIONS
  Postoperative outcomes were relatively acceptable. Surgery may be feasible and beneficial even for extremely aged patients 85 years and older, except for those with a performance status of 4.
authors.affiliation: Department of Surgery, National Hospital Organization Kure Medical Center/Chugoku Cancer Center, 3-1 Aoyama-cho, Kure, Hiroshima 737-0023, Japan. endos@kure-nh.go.jp
authors.forename: Shunji
authors.initials: S
authors.lastname: Endo
authors.forename: Yukinobu
authors.initials: Y
authors.lastname: Yoshikawa
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hatanaka
authors.forename: Harumi
authors.initials: H
authors.lastname: Tominaga
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hiraoka
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishitani
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Irei
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nakashima
authors.forename: Mi-Hwa
authors.initials: MH
authors.lastname: Park
authors.forename: Hiroyo
authors.initials: H
authors.lastname: Takahashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Wakahara
authors.forename: Wataru
authors.initials: W
authors.lastname: Kamiike
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*