Gastric resection in the aged (≥ 80 years) with gastric carcinoma: a multivariate analysis of prognostic factors

Kubota, Hirofumi; Kotoh, Tsukasa; Dhar, Dipok Kumar; Masunaga, Reiko; Tachibana, Mitsuo; Tabara, Hideki; Kohno, Hitoshi; Nagasue, Naofumi

doi:10.1046/j.1440-1622.2000.01802.x

Cited by 39 publications

(51 citation statements)

References 20 publications

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“…It is generally documented that gastric cancer in elderly patients is predominantly localized to the lower third of the stomach [6][7][8][9][14][15][16][17][18]. Previous reports demonstrated that the proportion (range, 42%-63%) of carcinomas in the lower third of the stomach in the elderly was higher than the proportion (range, 31%-44%) in the young [3,[6][7][8][9][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports demonstrated that the proportion (range, 42%-63%) of carcinomas in the lower third of the stomach in the elderly was higher than the proportion (range, 31%-44%) in the young [3,[6][7][8][9][14][15][16][17][18][19]. Our data confirmed that, in patients aged 85 years or older, cancers were situated more often in the lower third of the stomach compared with the younger age groups.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there was no clear trend of risk patterns involving carcinoma of the upper third of the stomach. Some investigators have reported that gastric cancer involving the upper third of the stomach in the elderly was more common than in younger groups [6,7,[15][16][17]19], whereas others found no significant difference or lower prevalence in the elderly group [3,8,14,18].…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have shown no significant difference in the incidence of lymph node metastasis between young and elderly patients with gastric cancer [3,[5][6][7][14][15][16][17][18][19]. Most of these reports did not take the clinical or pathological stage of the disease into account, and the results could not be simply compared with each other.…”

Section: Discussionmentioning

confidence: 99%

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Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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Background. The clinicopathologic features of gastric carcinoma in elderly people have been reported previously. The present study examined the patterns and distribution of gastric carcinomas in the elderly, especially in patients aged 85 and older. Methods. A retrospective study of 994 consecutive Japanese patients aged 65 years or older was performed. In this group, a total of 1147 lesions were analyzed. Pathological findings in the very old group (older than 85 years; n ‫؍‬ 126) were compared with those in younger groups (65-74 years [young-old group]; n ‫؍‬ 356) and (75-84 years [middle-old group]; n ‫؍‬ 512). Results. While the male-to-female ratio significantly decreased with advancing age, the relative odds of gastric cancer in men were higher than those in women in all age groups. In the very old group, cancer of the lower third of the stomach tended to increase with advancing age, and accounted for 43.7% of cases. In the population overall, differentiated-type adenocarcinoma accounted for 89.6% in the early cancers and 50.3% in the advanced cancers. The proportion of cases involving differentiated-type carcinoma significantly increased with advancing age in early cancer and female advanced cancer cases, whereas no significant change was found in male advanced-cancer patients. In the very old group, lymph node metastasis was found in 5.4% of early cancers and 72.7% in advanced cancers. Multiple cancers significantly increased with advancing age (P < 0.05; 10.7% in the younger-old group, 12.7% in the middle-old group, and 19.0% in the very old group). Conclusion. These results indicate that, in the very old group, gastric cancers showed a distal shift with predominantly differentiated-type carcinoma in the early stages and increased undifferentiated-type carcinomas in advanced stages. These results suggest increased histologic diversity with tumor growth. These findings have important implications for the screening and diagnosis of gastric cancer in the elderly. Offprint requests to: T. Arai

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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“…Kubota et al observed a higher, but statistically not significant, postoperative complications rate in octogenarian patients with curatively resected cancer and a postoperative mortality rate similar to that of patients aged 40-79 [50]. Kunisaki et al noted higher incidence of postoperative morbidity in the elderly among all registered patients-curatively and palliative resected [51].…”

Section: Japanese and Far East Studiesmentioning

confidence: 97%

Gastric cancer in the elderly: An overview

Saif

Makrilia

Zalonis

et al. 2010

European Journal of Surgical Oncology (EJSO)

138

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Aims: Gastric cancer in the elderly represents a distinct entity with specific clinicopathological characteristics and the majority of affected patients belong to this age group. Subtotal or total gastrectomy with radical lymph node dissection, adjuvant chemo-radiotherapy or perioperative chemotherapy represent the only potentially curative treatment options and seem to be performed with acceptable morbidity and mortality rates in selected elderly patients. Published research is very limited due to the strict selection and under-representation of elderly patients in clinical trials. A review of current recommendations and practice was performed.Methods: A comprehensive literature review was performed searching Medline for articles published since 1974, using "gastric cancer", "elderly" and "treatment" as key words.Observations: The data suggest that elderly patients that fulfill the inclusion criteria of clinical trials experience the same advantages and toxicities from chemotherapy as younger patients. Fit elderly patients with operable gastric cancer should be canndidates for the standard surgical resection provided that pre-operative comorbidities are taken into account. Peri-operative chemotherapy or post-operative chemoradiotherapy should be added in case of locally advanced disease. Palliative systemic chemotherapy seems to prolong survival in recurrent and metastatic disease.Conclusions: Chronological age alone is not sufficient reason to withhold curative or palliative treatment from an elderly gastric cancer patient. Performance status does not suffice in order to estimate the general condition of elderly patients and cofactors regarding their functional, social and mental status have to be considered.Word count (abstract): 234

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Clinicopathological aspects and prognostic value with respect to age: An analysis of 3,362 consecutive gastric cancer patients

Park

Lee

Kim

et al. 2009

Journal of Surgical Oncology

101

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Gastric resection in the aged (≥ 80 years) with gastric carcinoma: a multivariate analysis of prognostic factors

Abstract: Results indicate that gastric cancer in elderly patients has a poorer prognosis than that in younger patients.

Cited by 39 publications

References 20 publications

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Gastric cancer in the elderly: An overview

Clinicopathological aspects and prognostic value with respect to age: An analysis of 3,362 consecutive gastric cancer patients

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