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Survival analyses of elderly gastric cancer patients with or without surgery

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Abstract

Purpose

Deciding whether or not surgery should be performed for elderly patients is sometimes difficult. This study examined the prognosis of patients ≥ 80 years old with gastric cancer who underwent surgery or not.

Methods

The medical records of 111 patients who underwent surgery (surgery group) and 35 who received best supportive care (BSC group) were retrospectively reviewed, excluding those with clinical stage IVB disease, those with a performance status of 4, and those who underwent endoscopic submucosal dissection. The overall survival was compared between the two groups.

Results

The patients in the BSC group were significantly older and had worse performance status scores, worse physiological scores, and lower prognostic nutritional indexes than those in the surgery group. The patients in the surgery group showed a significantly better survival than those in the BSC group (median survival time, 38.9 vs. 11.4 months; p = 0.01) even after propensity score matching. In the subgroups of patients ≥ 90 years old and those with a performance status of 3, no marked difference in the survival between the 2 groups was observed.

Conclusions

Surgery imbued a survival benefit to elderly gastric cancer patients, except for those ≥ 90 years old and those with a performance status of ≥ 3. The surgical indication of patients ≥ 90 years old and those with a performance status of ≥ 3 requires careful deliberation.

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Acknowledgements

This study was funded by Kawasaki Medical School.

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Authors and Affiliations

  1. Department of Digestive Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan

    Shunji Endo, Yoshinori Fujiwara, Masaharu Higashida, Hisako Kubota, Hironori Tanaka, Toshimasa Okada, Kazuhiko Yoshimatsu & Tomio Ueno

  2. Department of Surgery, Mitsugi General Hospital, Hiroshima, Japan

    Hideo Matsumoto

  3. Department of General Geriatric Medicine, Kawasaki Medical School, Okayama, Japan

    Ken Sugimoto

Authors
  1. Shunji Endo
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  2. Yoshinori Fujiwara
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  3. Masaharu Higashida
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  4. Hisako Kubota
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  5. Hideo Matsumoto
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  6. Hironori Tanaka
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  7. Toshimasa Okada
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  8. Kazuhiko Yoshimatsu
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  9. Ken Sugimoto
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  10. Tomio Ueno
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Corresponding author

Correspondence to Shunji Endo.

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The authors have no financial conflicts of interest to disclose concerning this study.

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Endo, S., Fujiwara, Y., Higashida, M. et al. Survival analyses of elderly gastric cancer patients with or without surgery. Surg Today 52, 75–83 (2022). https://doi.org/10.1007/s00595-021-02303-8

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  • DOI: https://doi.org/10.1007/s00595-021-02303-8

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