Journal of Gastrointestinal Surgery

, Volume 17, Issue 12, pp 2067–2073 | Cite as

Postoperative Complications and Survival after Gastric Cancer Surgery in Patients Older than 80 Years of Age

  • Kazuhito Mita
  • Hideto Ito
  • Masatoshi Hashimoto
  • Ryo Murabayashi
  • Hideki Asakawa
  • Masashi Nabetani
  • Kazuya Koizumi
  • Takashi Hayashi
  • Keiichi Fujino
Original Article



This study sought to identify and evaluate the risk factors of postoperative complications, prognostic factors, and appropriate surgical strategies in elderly patients undergoing surgery for gastric cancer.


The medical records of 396 radical gastrectomies conducted from January 2006 to December 2011 were retrospectively reviewed. Surgical results and survival rates were assessed for 60 elderly patients (aged ≥ 80 years) and 336 non-elderly patients (aged < 80 years). The study groups were compared with respect to clinicopathological findings, surgical outcomes, and survival.


Elderly patients underwent gastrectomies with shorter operation time, showed less extensive lymphadenectomy, and had a significant difference in overall survival compared with non-elderly patients, although there was no difference in cause-specific survival among patients receiving curative resection. No significant risk factors affecting postoperative complications were identified in the elderly patients. Number of comorbidities (≥2) (HR, 5.30; 95 % CI, 1.11–25.32; P = 0.037) and TNM stage (≥II) (HR, 12.97; 95 % CI, 1.60–105.38; P = 0.017) were identified as independent prognostic factors in the elderly patients receiving curative resection.


Age is not an independent prognostic factor for patients receiving curative resection for gastric cancer. Multiple comorbidities may also influence the prognosis of elderly patients. Careful follow-up would improve overall survival for elderly patients.


Gastric cancer Elderly Survival Complication 





  1. 1.
    Saif MW, Makrilia N, Zalonis A, Merikas M, Syrigos K. Gastric cancer in the elderly: an overview. Eur J Surg Oncol. 2010;36:709–17.PubMedCrossRefGoogle Scholar
  2. 2.
    Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy—Japan Clinical Oncology Group study 9501. J Clin Oncol. 2004;22:2767–73.PubMedCrossRefGoogle Scholar
  3. 3.
    Degiuli M, Sasako M, Ponti A. Morbidity and mortality in the Italian Gastric Cancer Study Group randomized clinical trial of D1 versus D2 resection for gastric cancer. Br J Surg. 2010;97:643–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Park DJ, Lee HJ, Kim HH, Yang HK, Lee KU, Choe KJ. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg. 2005;92:1099–102.PubMedCrossRefGoogle Scholar
  5. 5.
    Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, et al. Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale Korean multicenter study. Ann Surg Oncol. 2008;15:2692–700.PubMedCrossRefGoogle Scholar
  6. 6.
    Hayashi T, Yoshikawa T, Aoyama T, Ogata T, Cho H, Tsuburaya A. Severity of complications after gastrectomy in elderly patients with gastric cancer. World J Surg. 2012;36:2139–45.PubMedCrossRefGoogle Scholar
  7. 7.
    Bittner R, Butters M, Ulrich M, Uppenbrink S, Beger HG. Total gastrectomy. Updated operative mortality and long-term survival with particular reference to patients older than 70 years of age. Ann Surg. 1996;224:37–42.PubMedCrossRefGoogle Scholar
  8. 8.
    Eguchi T, Takahashi Y, Ikarashi M, Kasahara M, Fujii M. Is extended lymph node dissection necessary for gastric cancer in elderly patients? Eur J Surg. 2000;166:949–53.PubMedCrossRefGoogle Scholar
  9. 9.
    Japanese Classification of Gastric Carcinoma—2nd English Edition. Gastric Cancer. 1998;1:10–24.Google Scholar
  10. 10.
    Mita K, Ito H, Fukumoto M, Murabayashi R, Koizumi K, Hayashi T, et al. Alternating treatment with S-1 plus low-dose cisplatin and S-1 alone for advanced gastric cancer. J Gastrointest Surg. 2011;15:791–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono HA, et al. Comparison of surgical outcomes of gastric cancer in elderly and middle-aged patients. Am J Surg. 2006;191:216–24.PubMedCrossRefGoogle Scholar
  12. 12.
    Fujiwara S, Noguchi T, Harada K, Noguchi T, Wada S, Moriyama H. How should we treat gastric cancer in the very elderly? Hepatogastroenterology. 2012;59:620–2.PubMedGoogle Scholar
  13. 13.
    Katai H, Sasako M, Sano T, Maruyama K. The outcome of surgical treatment for gastric carcinoma in the elderly. Jpn J Clin Oncol. 1998;28:112–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Orsenigo E, Tomajer V, Palo SD, Carlucci M, Vignali A, Tamburini A, et al. Impact of age on postoperative outcomes in 1118 gastric cancer patients undergoing surgical treatment. Gastric Cancer. 2007;10:39–44.PubMedCrossRefGoogle Scholar
  15. 15.
    Saidi RF, Bell JL, Dudrick PS. Surgical resection for gastric cancer in elderly patients: is there a difference in outcome? J Surg Res. 2004;118:15–20.PubMedCrossRefGoogle Scholar
  16. 16.
    Cho GS, Kim W, Kim HH, Ryu SW, Kim MC, Ryu SY. Multicentre study of the safety of laparoscopic subtotal gastrectomy for gastric cancer in the elderly. Br J Surg. 2009;96:1437–42.PubMedCrossRefGoogle Scholar
  17. 17.
    Kunisaki C, Makino H, Takagawa R, Oshima T, Nagano Y, Ono HA, et al. Efficacy of laparoscopy-assisted distal gastrectomy for gastric cancer in the elderly. Surg Endosc. 2009;23:377–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Vallejo AN. Immunological hurdles of ageing: indispensable research of the human model. Ageing Res Rev. 2011;10:315–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Hara H, Isozaki H, Nomura E, Fujii K, Sako S, Tanigawa N. Evaluation of treatment strategies for gastric cancer in the elderly according to the number of abnormal parameters on preoperative examination. Surg Today. 1999;29:837–41.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Kazuhito Mita
    • 1
  • Hideto Ito
    • 1
  • Masatoshi Hashimoto
    • 1
  • Ryo Murabayashi
    • 1
  • Hideki Asakawa
    • 1
  • Masashi Nabetani
    • 1
  • Kazuya Koizumi
    • 1
  • Takashi Hayashi
    • 1
  • Keiichi Fujino
    • 1
  1. 1.Department of SurgeryNew-Tokyo HospitalMatudoJapan

Personalised recommendations