Gastric cancer in the elderly

Lymphadenectomy in elderly/high risk patients: should it be different?

“…D2 lymphadenectomy, however, has a high operation-related death rate and is thought to be risky in elderly patients (32,33). Therefore many surgeons are reluctant to have elderly patients undergone extended gastric surgery (3,34,35), although a meta-analysis showed that perioperative mortality, still high in patients aged >80 years, is progressively decreasing in recent years (2).…”

“…Considering its prevalence in the seventh and eighth decade (2) and the global aging of population due to increased life expectancy (3), probably in a near future more elderly patients, with their age-related comorbidities, will be candidates for surgery for gastric carcinoma than in the past (4). This depicts the necessity to define whether guidelines, commonly based on trials involving young and middle-age patients, can be adopted also for the management of this frail population.…”

Is palliative resection necessary for gastric carcinoma patients?

“…Although the resectability of gastric carcinoma has increased from 37% before 1970 to 48% in 1990 [7], many [8] examined the therapeutic significance of noncurative resection for gastric carcinoma patients with hepatic metastasis and found that noncurative resection significantly prolonged the mean survival time of patients with limited hepatic metastasis when peritoneal dissemination was absent. Other studies reported a survival advantage of palliative resection but also stipulated that the number of sites of tumor spread should be considered when a palliative resection is performed in these patients [7,[9][10][11]. Regarding the number of sites of tumor spread, they suggested that resection had a survival advantage if the number of sites of tumor spread was two or less, but when the number of sites exceeded two, the survival advantage of resection disappeared.…”

Oxaliplatin, 5-FU, Folinic Acid as First-line Palliative Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer

“…Although elderly patients comprise a significant proportion of those patients with gastric cancer, and the elderly population is increasing (18), any large trials of palliative chemotherapy for elderly patients are almost lacking. Several phase II trials have been reported so far (19∼24).…”