title: [Clinicopathological characteristics of gastric cancer and survival improvement by surgical treatment in the elderly].
abstract: OBJECTIVE
  It has been known that elderly patients with gastric cancer show worse general condition and higher comorbidities. Therefore, few elderly patients undergo surgery. This study was designed to determine clinicopathological characteristics of gastric cancer in elderly patients and evaluate their survival improvements by the surgical treatment.
  
  
  METHODS
  Gastric cancer patients, diagnosed at Ewha Womans University Mokdong Hospital between 2000 to 2004, were divided into two groups those aged ≥65 years vs. <65 years. Clinicopathological characteristics, incidence of postoperative complications, and survival time of patients in each group were analyzed.
  
  
  RESULTS
  Total 370 patients were subjected and divided into the elderly and the younger group (55.4% vs. 44.6%). The elderly group showed higher incidences of hypertension and cardiovascular disease. Well differentiated adenocarcinoma was more frequently found in the elderly group (19.0% vs. 10.0%, p=0.025). There were no differences of operation time (242.6±70.7 vs. 257.3±83.8 min, p=0.115), postoperative hospital stays (15.8±10.6 vs. 14.7±9.8 days, p=0.361), and incidence of any complications (6.7% vs. 9.9%, p=0.309) between the two subgroups. The significant factors related with the elderly patient's survival were the tumor-node-metastasis (TNM) stage (stage I, hazard ratio [HR] 1.00; stage II, HR 1.28, 95% confidence interval [CI] 0.44-3.72; stage III, HR 4.06, 95% CI 2.08-7.92, stage IV, HR 9.78, 95% CI 4.97-19.26; p<0.001) and the treatment modality (laparoscopy, HR 1.00; open surgery, HR 3.90, 95% CI 2.43-6.26; p<0.001). The elderly patients who underwent gastric cancer surgery showed prolonged survival on TNM stage I, II, and III than those who were treated conservatively.
  
  
  CONCLUSIONS
  In the elderly patients with gastric cancer, those who had received surgical treatments showed significantly higher survival rate than those who had treated conservatively. Therefore, aggressive surgical treatments should be seriously considered even for the elderly patients with gastric cancer.
authors.affiliation: Department of Internal Medicine, Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Shim
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Roh
authors.forename: Chung Hyun
authors.initials: CH
authors.lastname: Tae
authors.forename: Seong-Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Jung
authors.forename: Tae-Hun
authors.initials: TH
authors.lastname: Kim
authors.forename: Sung-Ae
authors.initials: SA
authors.lastname: Jung
authors.forename: Kwon
authors.initials: K
authors.lastname: Yoo
authors.forename: Il Whan
authors.initials: IW
authors.lastname: Moon
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000369:Aged, 80 and over; D000375:Aging; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D002272:Carcinoembryonic Antigen