Short- and Long-Term Outcomes After Gastrectomy in Elderly Gastric Cancer Patients

Abstract

The number of elderly patients undergoing gastric cancer surgery has recently increased. We therefore evaluated the short- and long-term outcomes of elderly patients after curative gastrectomy. Overall, 824 patients were included in this retrospective study, which comprised of a non-elderly group (60-64years; n=558), an early-elderly group (75-79years; n=198), and a late-elderly group (≥80years; n=68) who underwent curative gastrectomy for gastric cancer between 2005 and 2009. Postoperative complications, according to the Clavien-Dindo classification, and survival of both elderly groups were compared with the non-elderly group. Postoperative life expectancy of the late-elderly group was compared with the corresponding aged general population. Overall and severe (grade III or higher) complications in the early-elderly group were comparable with the non-elderly group; however, those in the late-elderly group were significantly more common than in the non-elderly group (p=0.013 and p=0.043, respectively). Multivariable analysis revealed that age≥80years was an independent risk factor for severe complications (hazard ratio 3.02, 95% confidence interval 1.12-8.17; p=0.029), and the disease-specific survivals of both elderly groups were comparable with the non-elderly group in all TNM stages. Postoperative life expectancy of late-elderly patients eliminating death from recurrence was comparable with the corresponding aged general population eliminating death from gastric cancer. Gastric cancer surgery in elderly patients aged≥80years achieves reasonable long-term survival despite the increased risk of severe complications.