title: Safety and Survival Benefit of Surgical Management for Elderly Gastric Cancer Patients.
abstract: OBJECTIVE
  To study the safety and survival outcome of surgical management for elderly gastric cancer patients.
  
  
  METHODS
  Patients proven of gastric cancer who aged 80 years during November 2002 to July 2011 were retrospectively analyzed. The detailed information of patients' characteristics and surgical management was retrieved. Follow-up of overall survival status was performed to analyze the surgical effectiveness.
  
  
  RESULTS
  Totally, 92 (48 in surgery and 44 in non-surgery group) out of 187 eligible patients recorded adequate information and analyzed finally. Median ages were 81 years in surgery group and 83 year in non-surgery group. There were 34 patients undergone radical gastrectomy, 6 palliative gastrectomy, 1 gastrojejunostomy and 7 exploratory laparotomy. Median follow-up durations were 25 (9-111) and 28 (8-114) months in surgery and non-surgery groups, respectively (p = 0.797). Clinical-pathological T stage was 6 T1, 5 T2, 14 T3 and 23 T4 cases for surgery and 7 T1, 6 T2, 3 T3, 7 T4 and 21 TX cases for non-surgery. Clinical-pathological node status was 18 N0, 7 N1, 6 N2, 7 N3 and 10 NX cases for surgery and 10 N0, 3 N1, 3 N2, 3 N3 and 25 NX cases for non-surgery. Clinical-pathological distal metastasis status was 15 and 26 M1 cases for surgery and non-surgery, respectively (p = 0.006). Incidence of postoperative complications was 25.0% and postoperative hospital mortality was 2.1%. The 2-year survival rates were 30.8% and 8.0% for surgery and none-surgery, respectively (HR = 3.023, p = 0.001), and the 3-year survival rates were 17.6% and 0% for surgery and non-surgery, respectively (HR = 3.680, p = 0.001). In M0 subgroup, 2-year survival rate was 35.7% and 0.0% for surgery and non-surgery groups, respectively (HR = 3.98, p = 0.022).
  
  
  CONCLUSIONS
  The safety of surgery for well-selected ≥ 80-year elderly gastric cancer patients was potentially acceptable and the patients of early or locally advanced diseases could obtain survival benefits by surgery.
authors.forename: Yan-Mei
authors.initials: YM
authors.lastname: Bi
authors.forename: Xin-Zu
authors.initials: XZ
authors.lastname: Chen
authors.forename: Cheng-Kun
authors.initials: CK
authors.lastname: Jing
authors.forename: Ru-Bai
authors.initials: RB
authors.lastname: Zhou
authors.forename: Yu-Fei
authors.initials: YF
authors.lastname: Gaol
authors.forename: Li-Bo
authors.initials: LB
authors.lastname: Yang
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Chen
authors.forename: Kun
authors.initials: K
authors.lastname: Yang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Chen
authors.forename: Jia-Ping
authors.initials: JP
authors.lastname: Chen
authors.forename: Zong-Guang
authors.initials: ZG
authors.lastname: Zhou
authors.forename: Jian-Kun
authors.initials: JK
authors.lastname: Hu
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality; D015390:Gastric Bypass / Q000009:adverse effects; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D009367:Neoplasm Staging; D010166:Palliative Care; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome