Outcomes of surgical treatment of non-metastatic gastric cancer in patients aged 70 and older: A systematic review and meta-analysis

Argillander, Tanja E.; Festen, Suzanne; Zaag-Loonen, Hester J. van der; Graeff, Pauline de; Zaag, Edwin S. van der; Leeuwen, Barbara L. van; Nagengast, WB; Verhage, Roy J; Ruurda, Jelle P.; Munster, Barbara C. Van; Duijvendijk, Peter van

doi:10.1016/j.ejso.2022.05.003

Cited by 5 publications

(3 citation statements)

References 56 publications

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“…Therefore, the ERAS concept should also be tailored to individual patient circumstances and develop relative appropriate plans. [27] In this study, the ERAS group had fewer and milder postoperative complications compared to the control group. Previous studies have also shown that applying the ERAS perioperative care model is more effective for older patients with gastrointestinal cancer compared to traditional approaches.…”

Section: Discussionmentioning

confidence: 70%

Application of ERAS in older patients with gastric cancer

You,

Han

2024

Medicine

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Background: The purpose of this study was to investigate the effectiveness and feasibility of enhanced recovery after surgery (ERAS) in older gastric cancer (GC) patients by observing the changes in postoperative intestinal function recovery, nutritional indicators, and inflammatory markers following the surgery. Methods: A total of 61 older GC patients who underwent laparoscopic radical gastrectomy were selected as the subjects of this study. They were divided into an ERAS group (n = 28) and a conventional control group (n = 33) based on the different management modes during the perioperative period. General data, inflammatory response indicators, nutritional indicators, and perioperative indicators of the 2 groups were collected and compared. The changes in relevant indicators were analyzed, and the underlying reasons for these changes were explored. Results: There were no significant differences in general data and preoperative indicators between the 2 groups (P > .05). In the ERAS group, the inflammatory markers decreased more rapidly, and the nutritional indicators recovered more quickly after surgery. The differences between the 2 groups were statistically significant on the 5th and 7th postoperative days (P < .05). The ERAS group had significantly shorter postoperative hospital stay (10.07 ± 1.41 vs 13.04 ± 3.81), shorter time to first flatus (3.70 ± 0.72 vs 4.18 ± 1.17), shorter drainage tube retention time (8.96 ± 1.53 vs 10.93 ± 3.36), and shorter nasogastric tube retention time (3.36 ± 1.72 vs 6.14 ± 3.99) compared to the control group (P < .05). Conclusion: The application of the ERAS program in older GC patients is effective and feasible, and significantly contributes to faster postoperative recovery in older patients.

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Section: Discussionmentioning

confidence: 70%

Application of ERAS in older patients with gastric cancer

You,

Han

2024

Medicine

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“…However, five of these studies did not specify a cutoff age for the older population; instead, they analyzed a broad range of ages within this group. Among the identified studies, four focused on patients aged 65–75 years [ 13 14 15 16 ], one on patients aged 65–80 years [ 17 ], and one study on patients aged 65–85 years [ 18 ]. This lack of consistency in defining the “older” population can lead to issues with representativeness, variability within the age range, heterogeneity among the studies, and potential bias.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

Merga¹,

Lee

Gong

2023

J Gastric Cancer

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This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46–7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19–1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

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“…Currently, surgery is the primary treatment method for patients with GC and is key to improving survival rates[ 6 ]. The choice of surgical methods depends on the patient’s physical condition and tumor condition.…”

Section: Introductionmentioning

confidence: 99%

Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding

Feng¹,

Wang²,

Wang³

2023

World J Gastrointest Surg

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Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970. This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.

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Outcomes of surgical treatment of non-metastatic gastric cancer in patients aged 70 and older: A systematic review and meta-analysis

Cited by 5 publications

References 56 publications

Application of ERAS in older patients with gastric cancer

Application of ERAS in older patients with gastric cancer

Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding

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