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Surgical outcomes after gastrectomy in very elderly patients with gastric cancer

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Abstract

Purpose

Whether or not gastrectomy is feasible for very elderly gastric cancer patients is unclear. This study aimed to clarify the feasibility and safety of surgical treatment for patients in this age group.

Method

The study included 55 very elderly patients with resectable gastric cancer who underwent gastrectomy (≥ 85 years of age; very-E group). The surgical outcomes were compared with those of 611 elderly patients (75–84 years old; E group).

Results

Female sex, a poor physical and performance status, and a low serum albumin level patients were more frequent in the very-E group than in the E group. Lymphadenectomy was less aggressive in the very-E group than in the E group (P < 0.001). The overall postoperative complication rate was not significantly different between the groups (46 vs 33%; P = 0.073). A multivariate analysis to predict the overall survival identified male sex (hazard ratio 1.75, 95% confidence interval 1.30–2.36), low body mass index (2.19, 1.52–3.16), poor performance status (2.14, 1.60–2.86), low serum albumin level (1.84, 1.37–2.48), and advanced tumor stage (1.71, 1.29–2.27) but not age (1.31, 0.84–2.03) as independent prognostic factors.

Conclusion

Chronological age alone is not a contraindicative factor for gastrectomy in very elderly patients.

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Acknowledgements

This research was partially supported by the National Cancer Center Research and Development Fund (26-A-4). No preregistration exists for the reported studies reported in this article.

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Authors and Affiliations

  1. Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Makoto Hikage, Masanori Tokunaga, Rie Makuuchi, Tomoyuki Irino, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura & Masanori Terashima

  2. Department of Surgery, Sendai City Hospital, Sendai, Miyagi, Japan

    Makoto Hikage

  3. Gastric Surgery Division, National Cancer Center East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Masanori Tokunaga

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  1. Makoto Hikage
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  2. Masanori Tokunaga
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  5. Yutaka Tanizawa
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Corresponding author

Correspondence to Masanori Tokunaga.

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Conflict of interest

Hikage, Tokunaga, Makuuchi, Irino, Tanizawa, Bando, Kawamura, and Terashima have no conflicts of interest or financial ties to disclose.

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Hikage, M., Tokunaga, M., Makuuchi, R. et al. Surgical outcomes after gastrectomy in very elderly patients with gastric cancer. Surg Today 48, 773–782 (2018). https://doi.org/10.1007/s00595-018-1651-x

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  • DOI: https://doi.org/10.1007/s00595-018-1651-x

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