Abstract
The treatment strategies in patients with gastric cancer aged 80 years or older have not yet been well defined. We examined the incidence of postoperative complications and hospital mortality regarding the preoperative condition of such patients. A preoperative examination included evaluations of the cardiac, pulmonary, renal, and hepatic functions, the presence or absence of anemia, nutritional status, and blood sugar content. The incidence of postoperative complications and hospital mortality were then studied in relation to the number of preoperative abnormal parameters. The incidence of postoperative complications was 37.0%. The rate of hospital mortality was 11.1%. Among the patients with abnormalities in five or more items, the incidence of complications was 76.9% and the rate of hospital mortality was 23.1%. In the patients with an operative time of 4h or longer, the same incidence was 71.4%. Among the patients who underwent a curative resection, the 5-year survival rate was 92.3%. For elderly gastric cancer patients with abnormalities in five or more items during a preoperative examination and for those showing a poor level of daily life activity, a less invasive treatment modality should be planned. Patients with abnormalities of four or fewer items at a preoperative examination appear to be good candidates for curative resection.
Similar content being viewed by others
References
Maehara Y, Oshiro T, Oiwa H, Oda S, Baba H, Akazawa K, Sugimachi K (1995) Gastric carcinoma in patients over 70 years of age. Br J Surg 82:102–105
Noguchi Y, Imada T, Matsumoto A, Coit DG, Brennan MF (1989) Radical surgery for gastric cancer. A review of the Japanese experience. Cancer 64:2053–2062
Karl RC, Smith SK, Fabri PJ (1995) Validity of major cancer operations in eldely patients. Ann Surg Oncol 2:107–113
Nishimatsu S, Nomura H, Ohyanagi H (1994) Management of fluid-electrolyte metabolism in the elderly surgical patients. Gastroenterol Surg 17:1567–1575
Isozaki H, Okajima K (1974) How to reduce surgical complications after extended gastric surgery. Dig Surg 11:78–85
Saario I, Salo J, Lempinen M, Kivilaakso E (1987) Total and neartotal gastrectomy for gastric cancer in patients over 70 years of age. Am J Surg 154:269–270
Edelman DS, Russin DJ, Wallack MK (1987) Gastric cancer in the elderly. Am Surg 53:170–173
Roderich ES, Martin SK, Murray FB (1997) Factor predicting hospitalization after operative treatment for gastric carcinoma in patients older than 70 years. J Am Coll Surg 184:9–15
Fortner JG, Lauwers GY, Thaler HT, Concepcion R, Friedlander-Klar H, Kher U, Maclean BJ (1994) Nativity, complications, and pathology are determinants of surgical results for gastric cancer. Cancer 73:8–14
Schwarz RE, Karpeh MS, Brennan MF (1997) Factors predicting hospitalization after operative treatment for gastric carcinoma in patients older than 70 years. J Am Coll Surg 184:9–15
Masahiko N, Hideaki I, Eiji M, Ri G, Tetsuya T (1996) Promising operation for gastric patients 75 years of age and older. Preoperative determination using pentagon evaluation system. Jpn J Gastroenterol Surg 29:2033–2037
McGann KP, Bowman MA, Davis SW (1995) Morbidity, mortality and charges for hospital care on the elderly; a comparison of internist and family physicians admission. J Fam Prac 40:443–448
Bittner R, Schirrow H, Butters M, Roscher R, Kautzberger W, Oettinger W, Beger HG (1985) Total gastrectomy. A 15-year experience with particular reference to patients over 70 years of age. Arch Surg 120:1120–1125
Svartholm E, Larssom SA, Haglund U (1987) Total gastrectomy in elderly patients. Acta Chir Scand 153:677–680
Coloccia C, Ricci EB, Marzola GG, Molaschi M, Nano MG (1987) Gastric cancer in the elderly: results of surgical treatment. Int Surg 72:4–10
Japanese Research Society for Gastric Cancer (1995) Japanese classification of gastric carcinoma. First English edn. Kanehara, Tokyo
Ohyabu H, Matsuda S, Kurisu S, Hatta T, Koyama T, Kita Y, Umeki M, Kihana E, Nakajima K (1996) Risk factors of stomach cancer research in the elderly. Jpn J Gastroenterol Surg 29:2083–2091
Tsujitani S, Katano K, Oka M, Ikeguchi M, Maeta M, Kaibara N (1996) Limited operation for gastric cancer in the elderly. Br J Surg 83:836–839
Fujimoto S, Takahashi M, Ohkubo H, Mutou T, Masaoka H, Kobayashi K, Konno C (1994) Clinicopathologic characteristics and survival of elderly patients with gastric cancer. Surgery 14:1405–1408
Korenaga D, Moriguchi S, Baba H, Kakeji Yoshihiro, Orita H, Haraguchi M, Maehara Y, Ueo H, Sugimachi K (1991) Surgery for gastric carcinoma is feasible for patients over 80 years of age. World J Surg 15:642–648
Otani Y, Kumai K, Kubota T, Ohgami M, Hayashi N, Ishizuka H, Kitajima M (1996) Problems and settlement of surgery for elderly patients with gastric cancer based on experience with patients over 85 years old. Jpn J Gastroenterol Surg 29:2028–2032
Pacelli F, Bellantone R, Doglietto GB, Perri V, Genovese V, Tommasini O, Crucitti F (1991) Risk factors in relation to postoperative complications and mortality after total gastrectomy in aged patients. Am Surg 57:341–345
Viste A, Haugstvedt T, Eido GE, Sorreido O, Norwegian Stomach Cancer Trial Members (1988) Postoperative complications and mortality after surgery for gastric cancer. Ann Surg 207:7–13
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hara, H., Isozaki, H., Nomura, E. et al. Evaluation of treatment strategies for gastric cancer in the elderly according to the number of abnormal parameters on preoperative examination. Surg Today 29, 837–841 (1999). https://doi.org/10.1007/BF02482772
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02482772