title: How should we treat gastric cancer in the very elderly?
abstract: OBJECTIVE
  We aimed to clarify the clinicopathological features of gastric cancer in very elderly patients and to identify appropriate surgical therapy for them, focused particularly on their prognosis.
  
  
  METHODS
  Patients who underwent gastrectomy for gastric cancer in Oita University Hospital were included in this study. The patients were divided into two groups: the very elderly group (80 years or older) (E group) and the middle-aged group (ranging from 40 to 79 years) (M group). Their clinicopathological features and postoperative survival were compared.
  
  
  RESULTS
  Type 3,4 macroscopic types, INFγ and number of dissected lymph nodes were significantly less in the E group than in the M group (p=0.0092, p=0.0077, p=0.0475, respectively). Overall survival and disease-free survival were shorter for the E group (p=0.0898, p=0.0566, respectively). When other cause-related deaths were considered to be lost to follow-up, there was no significant difference between the E group and the M group.
  
  
  CONCLUSIONS
  Whenever radical resection is possible, surgical resection for gastric cancer, even in the very elderly, should not be denied. Nevertheless, surgeons should try to do less invasive surgery, especially for the very elderly.
authors.affiliation: Department of Gastrointestinal Surgery, Oita University, Oita, Japan. fshodroi@yahoo.co.jp
authors.forename: Shozo
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Noguchi
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Harada
authors.forename: Takuya
authors.initials: T
authors.lastname: Noguchi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Wada
authors.forename: Hatsuo
authors.initials: H
authors.lastname: Moriyama
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden