title: Feasibility of radical gastrectomy for elderly patients with gastric cancer.
abstract: BACKGROUND
  The aim of this study was to evaluate the short-term safety and long-term benefits of radical gastrectomy for gastric cancer in elderly patients.
  
  
  METHODS
  A total of 729 patients undergoing gastrectomy for adenocarcinoma between December 2008 and December 2011 were enrolled in this retrospective study. Patients were divided into three groups: young group (<65 years), young-old group (65-79 years) and old-old group (≥80 years).
  
  
  RESULTS
  Lower albumin levels, higher ASA grades, comorbidities, tumors located in the upper third of the stomach and advanced TNM stages were more common in the young-old and old-old age groups. Overall complications increased significantly with advancing age (15.4%, 24.9%, 48.7%, respectively); respiratory complications largely contributed to the dramatic increase. Severe complications were similar between the young and young-old groups (3.9%, 3.7%), but were significantly increased in the old-old group (12.8%). In multivariate analysis, old-old age, multiple comorbidities and no epidural use were strong predictors for overall complications. Both overall survival and disease-specific survival (DSS) rates declined with advancing age. Multivariate analysis showed that old-old age and TNM stage ≥ II were major independent risk factors for the DSS rate. When adjusted for confounding factors, young-old age was not a risk factor. The median survival time for the old-old patients with stage III tumors was 12.9 months.
  
  
  CONCLUSIONS
  It is relatively safe and beneficial for young-old patients to undergo radical gastrectomy as the young patients. However, the decision to perform radical gastrectomy for old-old patients with TNM stage III tumors should be made carefully.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Zhou
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: F-F
authors.initials: FF
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: C-L
authors.initials: CL
authors.lastname: Zhuang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: W-Y
authors.initials: WY
authors.lastname: Pang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: F-Y
authors.initials: FY
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: D-D
authors.initials: DD
authors.lastname: Huang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
authors.forename: S-L
authors.initials: SL
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. Electronic address: shenxian5166@126.com.
authors.forename: X
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China; Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China. Electronic address: yuzhen0577@gmail.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Yu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012140:Respiratory Tract Diseases / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D012709:Serum Albumin
keywords: Elderly patients; Gastrectomy; Gastric cancer; Postoperative complications; Survival