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Short- and Long-Term Outcomes After Gastrectomy in Elderly Gastric Cancer Patients
Yang JY, Lee HJ, Kim TH, Huh YJ, Son YG, Park JH, et al.
Ann Surg Oncol 2016 Aug 3. [Epub ahead of print]
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 (60-64 years; n = 558), an early-elderly group (75-79 years; n = 198), and a late-elderly group (≥80 years; 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 ≥80 years 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 ≥80 years achieves reasonable long-term survival despite the increased risk of severe complications.