Postoperative Chemotherapy for Gastric Cancer in the Elderly

Abstract

Prolongation of the life span and improvement in technology make it more likely that the elderly will be surgically treated and chemotherapy will be prescribed, postoperatively. The relationship between postoperative chemotherapy and survival time after resection for gastric cancer in the elderly was examined in a retrospective review of data on 268 patients over the afe of 70 years; all had been treated in the Department of Surgery II, between 1965 and 1987. Of these 268 patients, 161 were prescribed anticancer drugs, postoperatively. Postoperative chemotherapy was more often prescribed for those in the advanced stages of a malignancy. The survival time of those patients was shorter than for those who did not receive these drugs (p < 0.05). In a subgroup of our patients stratified to adjust for stage of the disease, there were no significant differences between the survival rates in cases of stages I, II or IV of the cancer. The survival time of patients with stage III and given chemotherapy improved compared to those not given chemotherapy (p < 0.01). Advanced chronological age is not sufficient justification to limit or withhold treatment with anticancer drugs. We propose that postoperative chemotherapy be prescribed for patients with gastric cancer, regardless of age.

Ergebnisse der chirurgischen Therapie des Magencarcinoms beim älteren Menschen

“…Studien, die mehrere Zeitabschnitte vergleichen, wie z. B. von Maehara et al [19,20], weisen fallende Morbiditä tszahlen nach. So wird die beobachtete Schwankungsbreite erklä rlich und relativiert.…”

“…Wä hrend im japanischen Schrifttum fü r die ü ber 70 jä hrigen 5-Jahres-Ü berlebensraten zwischen 47,2 und 62,6 % genannt werden [9,16,20], liegen die Zahlen westlicher Autoren mit 19,4 % [2] und 33 % (3 Jahre) [4] deutlich niedriger. Die signifikant schlechtere Ü berlebenswahrscheinlichkeit der ü ber 80 Jahre alten Patienten kann nur teilweise mit der natü rlichen Absterberate erklärt werden, da sich auch nach Alterskorrektur eine 5-Jahres-Ü berlebensrate von 22,4 % ergibt.…”