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World Journal of Surgery
Published in: World Journal of Surgery 8/2006

01-08-2006

Gastric Cancer Surgery in Elderly Patients

Authors: Stephen Gretschel, MD, Lope Estevez-Schwarz, MD, Michael Hünerbein, MD, Ulrike Schneider, MD, Peter M. Schlag, MD, PhD

Published in: World Journal of Surgery | Issue 8/2006

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Abstract

Background

To investigate the value of individual risk-adapted therapy in geriatric patients, we performed a consecutive analysis of 363 patients undergoing potentially curative surgery for gastric cancer.

Patients and Methods

All patients underwent extensive preoperative workup to assess surgical risk. The following criteria were evaluated in 3 age groups (< 60 years, 60–75 years, and > 75 years): comorbidity, tumor characteristics, type of resection, postoperative morbidity and mortality, recurrence rate, overall survival, and disease-free survival.

Results

There was an increased rate of comorbidity in the higher age groups (51% vs 76% vs 83%; P < 0.05). Cardiovascular and pulmonary diseases were most common. There was a decrease in the rate of both total gastrectomy (74%, 54%, 46%; P < 0.05) and D2 lymphadenectomy (78%, 53%, 31%; P <0.05). The 30-day mortality in the 3 age groups was 0%, 1%, and 8%, respectively (P < 0.05). There was only a slight difference in tumor recurrence rate (35%, 37%, and 27%; P = 0.437), with no significant difference in 5-year cancer-related survival (61%, 53%, 61%; P = 0.199).

Conclusions

Patient selection and risk-adapted surgery in elderly patients can result in acceptable therapeutic results comparable to younger patients. Limited surgery in elderly gastric cancer patients with high comorbidity does not necessarily compromise oncological outcome.
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Metadata
Title
Gastric Cancer Surgery in Elderly Patients
Authors
Stephen Gretschel, MD
Lope Estevez-Schwarz, MD
Michael Hünerbein, MD
Ulrike Schneider, MD
Peter M. Schlag, MD, PhD
Publication date
01-08-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 8/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0633-5

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