Surgical outcomes and prognostic factors of gastric cancer surgery in octogenarians

Abstract

Purpose: As the Korean population ages, an increasing number of elderly patients with gastric cancer are undergoing surgical resection. The aim of this study was to analyze the surgical outcomes and prognostic factors after gastric cancer surgery for patients 80 years of age or older. Methods: We analyzed the medical records of 720 patients with gastric cancer who underwent gastrectomy from March 2010 to December 2014 retrospectively. Patients were divided into two groups: octogenarians (age ≥80 years, n=46) and non-octogenarians (age <80 years, n=674). We evaluated clinicopathologic data including postoperative morbidity, mortality, and 5-year survival rate. Results: The rate of curative resection was not different between the two groups. The American Society of Anesthesiology score was significantly higher in the octogenarians (P<0.05). Octogenarians exhibited poorer performance scale scores, higher comorbidities, and more advanced TNM stages than non-octogenarians. There was no difference in surgical resection margins between the two groups. In addition, octogenarians suffered from more postoperative morbidity and mortality than non-octogenarians. In the analysis of risk factors of survival after gastrectomy for octogenarians, advanced TNM stage and dose of transfusion were independent risk factors. Overall survival was significantly lower in octogenarians than non-octogenarians. There was no difference in the disease-specific survival for each stage of cancer after adjustment for tumor stage. Conclusion: Octogenarians had more preoperative risk factors and postoperative morbidity and mortality, but cancer-specific survival was comparable with non-octogenarians. Careful preoperative evaluation, thorough resection, and attentive postoperative care can improve the overall survival of octogenarians with gastric cancer.

Prognostic Value of lncRNA PVT1 for Patients with Gastric Cancer: A Meta-Analysis

“…In 2015, the number of confirmed cases of gastric cancer in China was about 679000, only second to lung cancer (733000), higher than esophageal cancer (478000) and liver cancer (466000) [ 26 ]. Although great progress has been made in the surgical treatment and chemotherapy of gastric cancer in recent years, due to the lack of specific symptoms and signs in the early stage of gastric cancer, most patients with gastric cancer are in the advanced stage at the time of diagnosis, which seriously affects the prognosis of patients [ 27 ]. The 5-year survival rate of patients with advanced gastric cancer is less than 10% [ 28 ].…”