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Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association

Authors
  • Nunobe, Souya1
  • Oda, Ichiro2
  • Ishikawa, Takashi3
  • Akazawa, Kohei3
  • Katai, Hitoshi2
  • Isobe, Yoh4
  • Miyashiro, Isao5
  • Tsujitani, Shunichi6
  • Ono, Hiroyuki7
  • Tanabe, Satoshi8
  • Fukagawa, Takeo9
  • Suzuki, Satoshi10
  • Kakeji, Yoshihiro10
  • 1 Cancer Institute Ariake Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan , Tokyo (Japan)
  • 2 National Cancer Center Hospital, Tokyo, Japan , Tokyo (Japan)
  • 3 Niigata University Medical and Dental Hospital, Niigata, Japan , Niigata (Japan)
  • 4 National Hospital Organization Tokyo Medical Center, Tokyo, Japan , Tokyo (Japan)
  • 5 Osaka International Cancer Institute, Osaka, Japan , Osaka (Japan)
  • 6 Tottori University, Tottori, Japan , Tottori (Japan)
  • 7 Shizuoka Cancer Center, Shizuoka, Japan , Shizuoka (Japan)
  • 8 Kitasato University School of Medicine, Sagamihara, Japan , Sagamihara (Japan)
  • 9 Teikyo University School of Medicine, Tokyo, Japan , Tokyo (Japan)
  • 10 Kobe University Graduate School of Medicine, Kobe, Japan , Kobe (Japan)
Type
Published Article
Journal
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
Publication Date
Aug 26, 2019
Volume
23
Issue
2
Pages
328–338
Identifiers
DOI: 10.1007/s10120-019-01000-3
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundThe proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer.MethodsData from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes.ResultsPatients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was < 0.7% for any age group, but for those aged ≥ 75 years, the 60-day and 90-day mortality rates were 0.9–2.3% and 1.2–5.1%, respectively. An examination of long-term survival indicated that, as the class of age increased, the 5-year overall survival (OS) was 47.0–93.1% and disease-specific survival (DSS) was 91.4–98.2%, respectively. Although high DSS rates of ≥ 90% were found for all age groups, OS only accounted for ≤ 82% of patients aged ≥ 75 years.ConclusionAmong elderly patients with Stage I gastric cancer, deaths due to other diseases were frequently observed in the long term. Thus, for elderly patients, it may be appropriate to reconsider the treatment strategy with respect to the balance between the invasiveness of the treatment and the prognosis.

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