Short- and Long-Term Outcomes After Gastrectomy in Elderly Gastric Cancer Patients

Yang, Jun Young; Lee, Hyuk‐Joon; Kim, Tae Han; Huh, Yeon Ju; Son, Young Hoon; Park, Ji Ho; Ahn, Hye Young; Suh, Yun Suhk; Kong, Seong Ho; Yang, Han–Kwang

doi:10.1245/s10434-016-5482-y

Cited by 63 publications

(51 citation statements)

References 29 publications

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“…It is also the definition of elderly patients. It is classified as being over 70 years old, 10,11 over 75 years old, 4,12 over 80 years old 13,14 by each research. As the life expectancy increases, patients who underwent surgery with stomach cancer tend to be increasing.…”

Section: Discussionmentioning

confidence: 99%

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Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Kim

Lee

Choi

et al. 2017

J Minim Invasive Surg

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Purpose:As the life expectancy increases, the population of elderly patients increases. We evaluated the complications and survival rate of patients over 80 years old, who underwent laparoscopic gastrectomy.Methods: A retrospective analysis was conducted for a total of 1,912 patients, who underwent surgery with stomach cancer from 2008 to 2016. We analyzed postoperative complications and the survival rate between the middle old (70~79, n=255) group and the very old (≥80, n=37) group.Results: Among 1,912 patients, 255 people in the middle old group and 37 people within the very old group underwent laparoscopic gastrectomy. We confirmed that there was no significant difference except for the age (p<0.001) between the two groups. Overall complications were not statistically significantly different between the Middle old (70~79) group and the very old (≥80) group, 11.8% and 16.2%, respectively. There were also no statistically significant differences in severe complications beyond Clavien-Dindo classification Grade III. Risk factors for overall complications were higher in males than in females (p=0.002). Overall survival was statistically significantly lower with very old group (p<0.001).Conclusion: Laparoscopic gastrectomy in gastric cancer patients over 80 years of age is feasible and safe in terms of complications. However, considering the life expectancy, it seems necessary to pay attention to the patients who apply surgery.

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Section: Discussionmentioning

confidence: 99%

“…There are reports of an advanced stage of tumor growth, 16 prolonged operation times and excessive blood loss,17 gender (male), 13 ASA score 14 as independent prognostic factors affect- ing complications in elderly patients. In this study, only Gender (male) was risk factor in complications with univariable analysis.…”

Section: Discussionmentioning

confidence: 99%

Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Kim

Lee

Choi

et al. 2017

J Minim Invasive Surg

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“…These data indicate that extended lymphadenectomy can be performed safely in Western patients when adopting correct criteria and with an adequate surgical volume. Anyway, some risk factors for morbidity, linked to patient characteristics, have been identified in different studies: advanced age (particularly after 75 years), presence of important comorbidities (mainly cirrhosis and renal failure), high comorbidity index, hypoalbuminemia and poor nutritional status are those more frequently associated with advanced grade of postoperative complications after gastrectomy with lymphadenectomy (42,(44)(45)(46)(47). A characteristic of specialized centers is the ability to prompt identification and management of severe complications, which is associated with a significant decrease of their lethality rate.…”

Section: Early Resultsmentioning

confidence: 99%

Lymphadenectomy: state of the art

Marrelli

Franco

Iudici

et al. 2017

Transl. Gastroenterol. Hepatol.

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The extent of lymphadenectomy in gastric cancer (GC) surgery has been for long time a matter of debate. Randomized trials performed in the West reported worse results of D2 dissection, in terms of postoperative complications and long-term survival benefit, than Eastern series and observational studies from specialized Western centers. However, long-term re-evaluation of such trials and in depth-analysis of other experiences demonstrated the potential benefit of D2 in reducing the probability of cancer-related death and the safety of this procedure when avoiding unnecessary spleno-pancreatectomy and in centers with ad adequate surgical volume. Nowadays, the D2 is considered the standard treatment in most guidelines all over the world. More limited procedures (D1, D1 plus) may be adequate in selected cases, and more extended dissections (D2 plus) could be indicated in advanced forms with high risk of metastases to distant nodes, but in specialized centers or in the setting of clinical studies. The integration with neoadjuvant therapies and multimodality approach could offer a chance of cure in groups of patients with poor results when approached with standard treatment.

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“…The growing number of older patients with GC is apparently due to the high prevalence of H. pylori infection in this population, while the infection rate has decreased to less than 10% in the younger generation [3]. Advanced age is understandably associated with poor shortterm outcomes, such as a high postoperative morbidity rate [4] and more severe complications [5]. Furthermore, older patients generally have a high mortality rate from other causes as well as a relatively short life expectancy [6].…”

Section: Introductionmentioning

confidence: 99%

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

Sugawara

Aikou

Yajima

et al. 2020

Journal of Geriatric Oncology

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Short- and Long-Term Outcomes After Gastrectomy in Elderly Gastric Cancer Patients

Abstract: Gastric cancer surgery in elderly patients aged ≥80 years achieves reasonable long-term survival despite the increased risk of severe complications.

Cited by 63 publications

References 29 publications

Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Complications and Survival Rate of Patients Over 80 Years Old Who Underwent Laparoscopic Gastrectomy for Gastric Cancer

Lymphadenectomy: state of the art

Pre- and post-operative low prognostic nutritional index influences survival in older patients with gastric carcinoma

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