The Short- and Long-term Outcomes of Gastrectomy in Elderly Patients With Gastric Cancer

Abstract

Background: The short-and long-term outcomes of gastrectomy in elderly patients with gastric cancer have not been fully evaluated. Patients and Methods: Patients who underwent gastrectomy were classified into two groups: Nonelderly patients (<80 years old) and elderly patients (≥80 years old). The surgical morbidity, overall and cancerspecific survival in the two groups were compared. Results: A total of 411 patients were evaluated. The rate of overall complication was 29.4% in the non-elderly and 32.4% in the elderly (p=0.699). In the elderly, the overall and cancerspecific survival rates at 5 years after surgery were inferior to those of the younger group (59.8% vs. 66.7%, p=0.103 and 67.9% vs. 78.2%, p=0.028, respectively). Conclusion: The short-term outcomes after gastrectomy were almost equal for the two groups in the present study. The prognosis was poor in elderly patients, especially those with advanced gastric cancer. Gastric cancer is one of the main health problems (1). It is the fifth-most frequently diagnosed cancer and the third leading cause of cancer death worldwide. The 5-year survival rate ranges from 10.3% to 57.9% in all stages (1). Surgical resection is accepted as curative treatment for gastric cancer (2). However, complications after gastrectomy remain a clinically relevant problem. Indeed, the morbidity and mortality after gastric resection have been reported in the range of 22.0-42.9% and 0%-0.8%, respectively (3-6). The number of elderly patients is increasing worldwide, with the proportion of elderly over 80 years old increasing at a rate of 4.0% annually (7). In elderly patients, conditions such as functional impairment and physiological problems are common, which can result in postoperative complications and poor survival (8-10). Surgical procedures, perioperative care, and surgical strategies should thus be carefully planned for elderly patients. However, there have been few previous studies reporting on the safety and feasibility of gastric cancer surgery for older patients. Furthermore, the long-term survival of elderly patients after gastric cancer surgery is largely still unknown. It is therefore essential to clarify characteristics of elderly patients and assess the effect of age on their treatment outcomes. The present retrospective study compared the short-and long-term outcomes after gastric cancer surgery in elderly patients with those in non-elderly patients. Patients and Methods Patients. The study subjects were collected from among consecutive patients in the hospital registry indicated for gastric cancer surgery at the Yokohama City University Hospital between January 2000 and September 2012. Patients with the following were enrolled: Histologically proven gastric adenocarcinoma, no metachronous or concurrent malignancies, and gastrectomy for gastric cancer with curative D1+ or D2 dissection as a first-line treatment. The removed tumor specimens were examined histopathologically, and staging was performed based on tumor invasion and lymph node metastasis, in line with th...

Enhancing surgical outcomes in elderly gastric cancer patients: the role of comprehensive preoperative assessment and support

“…Studies have consistently shown that postoperative complications are associated with decreased long-term survival and increased long-term morbidity [ 34 – 39 ]. Our findings align with research suggesting that comprehensive preoperative supports can lead to a substantial reduction in these complications, thereby improving not only short-term outcomes but also long-term prognosis [ 40 – 42 ]. Moreover, the observed shorter hospital stays in the CPAS group align with studies indicating that enhanced recovery protocols, which include preoperative optimization, can expedite patient recovery and reduce healthcare costs [ 43 , 44 ].…”

Gastric Cancer in Older Patients: A Retrospective Study and Literature Review

“…A previous study reported similar short-term outcomes according to age but inferior long-term prognosis in older adult patients and those with advanced cancer; therefore, the indications for surgery in older adult patients with advanced cancer require careful consideration. 20 ) Lim et al 4 ) analyzed 1,107 patients who underwent surgery for GC between 2005 and 2009 by classifying them into three age groups (<65, 65–74, and ≥75 years) and observed were more advanced diseases and synchronous cancers in the older groups, suggesting the need for caution before determining the treatment method in these patients.…”

Technical and oncological safety of laparoscopic gastrectomy for gastric cancer in elderly patients ≥ 80 years old

“…Other authors showed similar results. Komori et al reported that the short-term outcomes after gastrectomy without regard to approach were almost equal between non-elderly and elderly patients [ 26 ]. Mikami et al also showed that there were no differences in short-term outcomes including postoperative morbidity between elderly and non-elderly patients who underwent LG [ 27 ].…”