Surgical outcomes and prognostic factors of gastric cancer surgery in octogenarians
- Author:
Ik Beom SHIN
1
;
Sung Jin OH
;
Byoung Jo SUH
Author Information
- Publication Type:Original Article
- Keywords: Gastric cancer; Octogenarian; Treatment outcome; Prognostic factor
- MeSH: Aged; Aged, 80 and over; Anesthesiology; Comorbidity; Gastrectomy; Humans; Medical Records; Mortality; Postoperative Care; Retrospective Studies; Risk Factors; Stomach Neoplasms; Survival Rate; Treatment Outcome
- From: Korean Journal of Clinical Oncology 2019;15(2):112-120
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: As the Korean population ages, an increasing number of elderly patients with gastric cancer are undergoing surgical resection. The aim of this study was to analyze the surgical outcomes and prognostic factors after gastric cancer surgery for patients 80 years of age or older.METHODS: We analyzed the medical records of 720 patients with gastric cancer who underwent gastrectomy from March 2010 to December 2014 retrospectively. Patients were divided into two groups: octogenarians (age ≥80 years, n=46) and non-octogenarians (age <80 years, n=674). We evaluated clinicopathologic data including postoperative morbidity, mortality, and 5-year survival rate.RESULTS: The rate of curative resection was not different between the two groups. The American Society of Anesthesiology score was significantly higher in the octogenarians (P<0.05). Octogenarians exhibited poorer performance scale scores, higher comorbidities, and more advanced TNM stages than non-octogenarians. There was no difference in surgical resection margins between the two groups. In addition, octogenarians suffered from more postoperative morbidity and mortality than non-octogenarians. In the analysis of risk factors of survival after gastrectomy for octogenarians, advanced TNM stage and dose of transfusion were independent risk factors. Overall survival was significantly lower in octogenarians than non-octogenarians. There was no difference in the disease-specific survival for each stage of cancer after adjustment for tumor stage.CONCLUSION: Octogenarians had more preoperative risk factors and postoperative morbidity and mortality, but cancer-specific survival was comparable with non-octogenarians. Careful preoperative evaluation, thorough resection, and attentive postoperative care can improve the overall survival of octogenarians with gastric cancer.
