Abstract
BackgroundThe proportion of early gastric cancer stages is increasing, as is the incidence of gastric cancer among the elderly population. Therefore, this study was designed to analyze surgical treatment outcomes of T1-T2 gastric cancer in elderly patients.MethodsA total of 457 patients with T1-T2 gastric cancer who underwent gastrectomy between 2005 and 2015 were enrolled in this retrospective study. Patients were classified into two groups according to age (< 70 years versus ≥ 70 years). Clinicopathological features, surgical treatment results, and clinical outcomes were compared between the groups.ResultsHigher ASA score (ASA 3/4), differentiated cancer, and intestinal-type tumors were more common in elderly patients. Postoperative complication rates were similar between the two groups; however, postoperative mortality rates were significantly higher in the elderly group. Higher ASA score was independently associated with postoperative complications in the elderly group. Furthermore, severe postoperative complications were found as an independent factor associated with higher 90-day mortality rate. Elderly patients had a significantly poorer 5-year overall survival rate. Two surgery-related factors—total gastrectomy and complicated postoperative course—were revealed as independent prognostic factors for poor overall survival in the elderly group.ConclusionsDespite higher postoperative mortality rate and poorer overall survival results, elderly patients with gastric cancer should be considered for radical surgery. ASA score may be useful for predicting surgical treatment outcomes in elderly patients undergoing surgery for GC and hence assists clinicians in planning treatment strategies for each individual patient.
Highlights
The proportion of early gastric cancer stages is increasing, as is the incidence of gastric cancer among the elderly population
The increasing lifetime expectancy and improved treatment of age-related chronic diseases have led to a greater number of older patients suffering from gastric cancer (GC), who can be potentially cured by surgical resection
The aim of our study was to analyze the differences in surgical treatment outcomes between elderly and nonelderly patients with early invasion gastric cancer
Summary
The proportion of early gastric cancer stages is increasing, as is the incidence of gastric cancer among the elderly population. Treatment strategy of gastric cancer has dramatically changed during the last decades mainly as Bausys et al World Journal of Surgical Oncology (2018) 16:79 up to 66% [7]. Despite these advancements, such favorable outcomes will be difficult to maintain in the increasing aging population. Identification of factors affecting short-term and long-term surgical treatment outcomes in elderly is essential for treatment personalization and optimization. This is especially significant for a cohort of patients in which excellent outcomes can be expected. Because early GC stages are relatively rare in the West, only limited data are available to guide treatment decisions for such a population
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