J Korean Surg Soc.  2012 Apr;82(4):211-218. 10.4174/jkss.2012.82.4.211.

Impact of chronologic age in the elderly with gastric cancer

• Lee SR
• Kim HO
• Yoo CH

• KMID: 1820068
• DOI: http://doi.org/10.4174/jkss.2012.82.4.211

Abstract

PURPOSE
Although the incidence of gastric cancer has declined in the general population, it is the second most frequent cause of death due to malignancy in the world with its incidence in the elderly increasing as a result of increased life expectancy. This present study tried to find the optimal treatment for patients aged 75 years or older with gastric cancer through comparison of the clinicopathological characteristics, surgical outcomes, and identifying prognostic factors of survival.
METHODS
Elderly patients who underwent gastric resection for gastric cancer from January, 1999 to February, 2009 (n = 470) were divided into two groups: very elderly patients, 75 years or older (n = 95), and younger elderly patients, between 65 and 74 years old (n = 365).
RESULTS
Distinct characteristics of very elderly patients included more frequent underlying disease, deeper invasion, and more frequent lymph node metastasis. There were significant differences in overall survival between the two groups at stages III-B and IV. However, postoperative hospital stays, postoperative morbidity, mortality and early stage did not differ between curatively resected patients in the two groups.
CONCLUSION
Due to improved postoperative care, gastrectomy of gastric cancer is the treatment of choice in very elderly patients. Therefore, early diagnosis through regular medical screening and curative gastrectomy with lymph node dissection should be performed in very elderly gastric cancer patients.

Keyword

Elderly; Gastric cancer; Geriatric surgery

MeSH Terms

Aged
Cause of Death
Early Diagnosis
Gastrectomy
Humans
Incidence
Length of Stay
Life Expectancy
Lymph Node Excision
Lymph Nodes
Mass Screening
Neoplasm Metastasis
Postoperative Care
Stomach Neoplasms

Figure

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  Fig. 1 Survival of very elderly patients (≥75 years) and younger elderly patients (65 to 74 years) after curative resection. There were significant differences in overall survival between the two age groups (P = 0.021).

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  Fig. 2 Survival of very elderly patients (≥75 years) and younger elderly patients (65 to 74 years) after palliative resection. There was no significant difference in overall survival between the two age groups (P = 0.063).

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