Abstract
BackgroundThe aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer.MethodsThe medical records of 366 patients with gastric cancer who underwent surgical resection at our hospital between January 2007 and December 2014 were retrospectively reviewed. Of the 366 patients, 117 were aged 75 years or older and 249 were aged 74 years or younger. All factors that were identified as significant using univariate analysis were included in the multivariate analysis.ResultsThe median follow-up duration was 52.9 months (range, 1.0–117.5 months). We found that in patients aged 75 years or older, postoperative complications and the extent of cancer were independent prognostic factors of overall survival and disease-free survival. In contrast, in patients aged 74 years or younger, only the lymph node status and postoperative chemotherapy were independent prognostic factors for overall survival and disease-free survival, respectively.ConclusionsPathological outcomes and postoperative complications are important prognostic factors for survival in patients aged 75 years or older with gastric cancer, whereas pathological outcomes and postoperative chemotherapy are important prognostic factors for survival in patients aged 74 years or younger. Because the prevention of postoperative complications may contribute to improvements in the prognosis of elderly patients with gastric cancer, we suggest that it is necessary to consider limited surgery instead of radical surgery, depending on the patient’s general condition and co-morbidities.
Highlights
The aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer
Patients We investigated a total of 494 consecutive patients with a histologically confirmed diagnosis of gastric cancer who were indicated for surgical treatment
We demonstrated that the stage of cancer progression, Onodera prognostic nutritional index (PNI), and postoperative complications were prognostic indicators for Overall survival (OS) and Diseasespecific survival (DSS) in patients with gastric cancer aged 75 years or older
Summary
The aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer. Gastric cancer is the fourth most common malignant disease and the second leading cause of cancer-related deaths worldwide [1]. Mortality from gastric cancer has significantly decreased in Japan because of advances in diagnostic and treatment modalities, including improvements in screening, surgery, and chemotherapy [2]. Radical gastrectomy is the mainstay of curative treatment for gastric cancer. Characteristics of elderly patients such as declining physiological function, poor nutritional status, and surgical trauma from radical gastrectomy appear to result in higher postoperative morbidity, prolonged hospital stays, increased healthcare costs, and higher postoperative mortality. Perioperative nutritional support and preoperative rehabilitation are beneficial for elderly patients with gastric cancer and can reduce surgical complications and mortality [4, 5]
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