Postoperative complications in elderly patients with gastric cancer

Takeuchi, Daisuke; Koide, Naoki; Suzuki, Akira; Ishizone, Satoshi; Shimizu, Fumiaki; Tsuchiya, Takuji; Kumeda, Shigeyoshi; Miyagawa, Shinichi

doi:10.1016/j.jss.2015.03.095

Cited by 73 publications

(62 citation statements)

References 36 publications

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“…On the other hand, some studies reported that postoperative complications were associated with poor prognosis in patients with GC. 3,4,33 However, herein we could not conclude that the PNI affected the prognosis of GC patients by affecting the occurrence of postoperative complications. Therefore, further studies are needed to elucidate this issue.…”

Section: Discussioncontrasting

confidence: 67%

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

Yang¹,

Gao²,

Song

et al. 2016

European Journal of Surgical Oncology (EJSO)

200

154

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Section: Discussioncontrasting

confidence: 67%

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

Yang¹,

Gao²,

Song

et al. 2016

European Journal of Surgical Oncology (EJSO)

200

154

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“…Regarding gastric cancer, infectious complications after gastrectomy caused by anastomotic leakage, procedure‐related infection or any type of infection were reported to have a negative effect on survival . For elderly patients, severe postoperative complications were reported to be associated with worse clinical outcomes . However, these investigations did not focus solely on the impact of postoperative pneumonia on long‐term survival.…”

Section: Discussionmentioning

confidence: 97%

“…Several studies have reported that pulmonary complications negatively affect not only short‐term mortality but also long‐term survival after thoracic surgeries such as resection of esophageal and lung cancer . Although a previous study reported that patients with postoperative pneumonia following gastrectomy had high postoperative mortality, the potential long‐term impact of postoperative pneumonia has not been investigated. Identification of risk factors for postoperative pneumonia may have a crucial role in the development of therapeutic strategies to reduce the incidence and impact of pneumonia in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Long‐term impact of postoperative pneumonia after curative gastrectomy for elderly gastric cancer patients

Suzuki

Kanaji

Matsuda

et al. 2017

Annals of Gastroent Surgery

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With the extension of life expectancy, cancer has been increasing in elderly populations. Postoperative pneumonia can negatively influence immediate mortality following gastrectomy for elderly patients, but its impact on long‐term survival remains unclear. We retrospectively reviewed the cases of patients aged ≥75 years who underwent curative gastrectomy for gastric cancer from 2000 to 2014 to determine the long‐term effects of postoperative pneumonia and to identify independent risk factors along with physical status and surgical procedure. Of 250 patients, 32 (12.8%) developed postoperative pneumonia. Patients with postoperative pneumonia had significantly worse overall survival (OS) than those without postoperative pneumonia (P<.001). A multivariate analysis identified postoperative pneumonia as a prognostic factor for OS (hazard ratio, 2.06; 95% CI, 1.05‐3.75; P=.036). Significant risk factors for the development of postoperative pneumonia were male gender (P=.026) and D2 lymphadenectomy (P<.001). D2 lymphadenectomy was associated with poorer OS than D1 or D1+lymphadenectomy in patients with an American Society of Anesthesiologists (ASA) score 3 (P=.026), but did not influence OS negatively in patients with an ASA score ≤2. Limited lymphadenectomy did not affect the cancer‐specific survival of elderly patients with ASA score 3. Postoperative pneumonia following gastrectomy has an adverse impact on the long‐term survival of elderly gastric cancer patients. A limited lymphadenectomy during curative resection should be considered to prevent postoperative pneumonia in frail elderly patients with ASA score 3. Postoperative pneumonia following gastrectomy has an adverse impact on the long‐term survival of elderly gastric cancer patients. Extent of lymph node dissection during curative resection should be limited to prevent postoperative pneumonia, based on the patient's frailty.

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“…62 It is important to discern the prevalence and impact of delirium in older patients with cancer since the risk of delirium is associated with both increased age 63 and malignancy. 64 Estimates of the prevalence of delirium in patients with cancer range widely from 10% to 50% among inpatients undergoing cancer surgery 65–69 and 20% to 90% among patients with advanced cancer receiving palliative care. 70–73 Without routine evaluation for delirium in outpatient cancer clinics, it is difficult to estimate the true prevalence of delirium among patients with cancer.…”

Section: Gap 4: Patients With Cancer Are Not Routinely Screened Fomentioning

confidence: 99%

Understanding cognition in older patients with cancer

Karuturi

Wong

Hsu

et al. 2016

Journal of Geriatric Oncology

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Cancer and neurocognitive disorders, such as dementia and delirium, are common and serious diseases in the elderly that are accompanied by high degree of morbidity and mortality. Furthermore, evidence supports the under-diagnosis of both dementia and delirium in older adults. Complex questions exist regarding the interaction of dementia and delirium with cancer, beginning with guidelines on how best measure disease severity, the optimal screening test for either disorder, the appropriate level of intervention in the setting of abnormal findings, and strategies aimed at preventing the development or progression of either process. Ethical concerns emerge in the research setting, pertaining to the detection of cognitive dysfunction in participants, validity of consent, disclosure of abnormal results if screening is pursued, and recommended level of intervention by investigators. Furthermore, understanding the ways in which comorbid cognitive dysfunction and cancer impact both cancer and non-cancer-related outcomes is essential in guiding treatment decisions. In the following article, we will discuss what is presently known of the interactions of pre-existing cognitive impairment and delirium with cancer. We will also discuss identified deficits in our knowledge base, and propose ways in which innovative research may address these gaps.

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Postoperative complications in elderly patients with gastric cancer

Cited by 73 publications

References 36 publications

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

The prognostic nutritional index is a predictive indicator of prognosis and postoperative complications in gastric cancer: A meta-analysis

Long‐term impact of postoperative pneumonia after curative gastrectomy for elderly gastric cancer patients

Understanding cognition in older patients with cancer

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