1.A Study of Surgical Treatment of Gastric Cancer in the Elderly. Comparative Investigation between Patients Aged Seventies and Eighty and above.
Noboru Sasaki ; Shigenobu Kado ; Masaharu Kawaguchi ; Shuji Kohata ; Masafumi Sueshiro ; Yoshikata Eguchi ; Tatsuo Nishino
Journal of the Japanese Association of Rural Medicine 1992;40(5):1030-1035
A clinical study was made on a total of 478 stomach cancer cases that had been subjected to surgery during the 12-year period from 1978 to 1989. Of the total, 34.1% were accounted for by the patients aged 70 years and above. Those old patients were divided into the two groups-those in their 70s and those in their 80s and above. The clinical cases of the two aged groups were studied in comparison with the cases of the patients aged 69 and below (65.9%). The number of early stomach cancer cases was smallest in the 70s age group. However, in this age group, advanced cancer was largest in number, metastases to lymph nodes, peritonea, and the liver were observed in many cases, and the curative resection rate was low. In the age group of 80 and above, either early cancer or advanced cancer was large in number. Apparently moderation was exercised in performing surgerical operations on the persons of advanced age. It was found that R2 lymph node dissection had been confined to 68.4% of the patients aged 80 and above, but that the curative resection rate was highest with 84.2% probably because limited lymph node metastasis. In this age group, a majority of cancers occurred at the antral region. A tendency was observed that cancer occurs less at the lesser curvature and on the posterior wall of the stomach and much more freqently at the greater curvature and on the anterior wall. Histologically, the tumor cells were mostly of a highly differentiated, localized type. Although high risk is involved in surgery in the elderly patients, many cases of stomach cancer are operable. So, it would be worth physicians' intention to risk operations while taking precautions against postoperative complications, with a view to improving the cure rate and helping the patients to upgrade the quality of life in their remining years.