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29-04-2022 | Gastrectomy | Original Article

Survival benefits of gastrectomy compared to conservative observation for older patients with resectable gastric cancer: a propensity score matched analysis

Authors: Shuhei Ito, Kippei Ohgaki, Tetsuro Kawazoe, Huanlin Wang, Toshihiko Nakamura, Shinichiro Maehara, Eisuke Adachi, Yoichi Ikeda, Yoshihiko Maehara

Published in: Langenbeck's Archives of Surgery | Issue 6/2022

Abstract

Purpose

Radical gastrectomy is considered the first choice of curative treatment for older patients with gastric cancer (GC). However, there is limited data on the survival benefits of gastrectomy for older patients with GC.

Methods

This was a retrospective observational study where medical records of patients aged ≥ 75 years with clinically resectable primary GC, comprising 115 patients who underwent radical surgery (S group) and 33 patients who received conservative therapy (non-S group) (total cohort) and 44 propensity-matched patients (matched cohort), were reviewed. Survival and independent risk factors, including comorbidities and systemic nutritional and inflammatory statuses, were evaluated.

Results

In the total cohort, the 5-year overall survival (OS) in the S group was significantly higher than that in the non-S group (53.7% vs 19.7%, P < 0.0001). In the matched cohort, the 3-year OS in the S group was significantly higher than that in the non-S group (59.4% vs 15.9%, P < 0.01). Multivariate analysis of the total cohort showed that no surgery was an independent prognostic factor for poor OS (hazard ratio (HR) 3.70, 95% confidence interval (CI) 1.91–7.20, P = 0.0001). In the S group in the total cohort, the multivariate analysis showed that renal disease (HR 2.51, 95% CI 1.23–5.12, P < 0.05) was an independent prognostic factor for poor OS.

Conclusions

Gastrectomy for older patients improved the prognosis; however, careful patient selection is essential, especially among those with renal disease.

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Title: Survival benefits of gastrectomy compared to conservative observation for older patients with resectable gastric cancer: a propensity score matched analysis
Authors: Shuhei Ito
Kippei Ohgaki
Tetsuro Kawazoe
Huanlin Wang
Toshihiko Nakamura
Shinichiro Maehara
Eisuke Adachi
Yoichi Ikeda
Yoshihiko Maehara
Publication date: 29-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Gastrectomy
Gastric Cancer
Gastric Cancer
Gastrectomy
Published in: Langenbeck's Archives of Surgery / Issue 6/2022
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-022-02511-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Survival benefits of gastrectomy compared to conservative observation for older patients with resectable gastric cancer: a propensity score matched analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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