Journal of Aging Science

Abstract

Surgical Treatment for Gastric Cancer in Extremely Aged Patients

Atsushi Matsuki, Atsushi Nashimoto, Hiroshi Yabusaki and Masaki Aizawa

Objectives: Average human life expectancy is 82.6 years old in Japan. We report surgical treatment for extremely aged patients with gastric cancer.

Methods: Between 1991 and 2011, 5330 gastric cancer patients were underwent gastrectomy in our hospital, and 78 patients (1.5%) were over 85 years old. The clinic-pathological findings in these patients were investigated retrospectively and compared with those in 4494 patients under 75 years old.

Results: Median age was 86 (85-95) vs. 63 (19-75). The types of gastrectomy such as local/proximal/distal/total were 9/0/49/20 vs. 216/172/2983/1123. Preoperative morbidity rate was 73.1% vs. 23.2%. The ratio of extent nodal dissection was 30.8% vs. 53.5%. Postoperative morbidity/30-day mortality rate was 24.4%/1.3% vs. 15.3%/0.2%, especially pneumonia; brain infarction and urinary tract infection were more common in elderly group. Best supportive care is highly selected in case of recurrence in elderly group (66.7% vs. 11.9%). The overall 5-year survival rate of StageI/II/III/IV was 70.6/70.0/30.3/0% vs. 92.0/80.0/60.5/13.3%. The ratio of non-cancer death within 5 years after operation was 19.2% vs. 5.8%.

Conclusion: Although the postoperative complications and non-gastric cancer death are high ratio, cautious operative procedure contributes to a good results and prognosis even in the extremely aged patients.