title: Postoperative complications in elderly patients with gastric cancer.
abstract: BACKGROUND
  Elderly patients undergoing gastrectomy are expected to be at high risk of postoperative complications. This retrospective multicenter cohort study assessed complications and long-term outcomes after gastrectomy for gastric cancer (GC).
  
  
  METHODS
  A total of 993 patients with GC who had undergone gastrectomy were included, comprising 186 elderly patients (age ≥ 80 y, E group) and 807 nonelderly patients (age ≤ 79 y, NE group). Preoperative comorbidities, operative results, postoperative complications, and clinical outcomes were compared between the groups.
  
  
  RESULTS
  Clavien-Dindo grade ≥1 postoperative complications, pneumonia (P = 0.02), delirium (P < 0.001), and urinary tract infection (P < 0.001) were more common in the E group. Postoperative pneumonia was associated with mortality in this group (P < 0.001). Three patients (1.6%) died after surgery, each of whom had pneumonia. Severe postoperative complication was independently prognostic of overall (hazard ratio, 4.69; 95% confidence interval, 2.40-9.14; P < 0.001) and disease-specific (hazard ratio, 6.41; 95% confidence interval 2.92-14.1; P < 0.001) survival in the E group.
  
  
  CONCLUSIONS
  In elderly patients with GC, clinical outcomes are strongly associated with severe postoperative complications. Preventing such complications may improve survival.
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: takeuchi_daichan@yahoo.co.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takeuchi
authors.affiliation: Department of Surgery, Nagano Prefectural Kiso Hospital, Fukushima, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Koide
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishizone
authors.affiliation: Department of Surgery, Shinshu Ueda Medical Center, Ueda, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Shimizu
authors.affiliation: Department of Surgery, Shinshu Ueda Medical Center, Ueda, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Surgery, Nagano Prefectural Kiso Hospital, Fukushima, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Kumeda
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: Elderly; Gastric cancer; Postoperative complication