Surgical results in patients 75 years and older with gastric cancer

With the increase in life expectancy, the proportion of elderly patients with gastric cancer is constantly increasing.Objective: To research the clinical and morphological features and possibilities of surgical treatment of gastric cancer in patients 75 years and older.Materials and methods: A retrospective analysis of 839 patients with GC underwent to surgical treatment in the thoraco-abdominal department Russian cancer research center N.N.Blokhin during 1990-2010 years. 286 elderly patients (>75 years), including 62 patients over 80 years. Patients <75 years (n=553) in the control group.Results: The study of clinical and morphological characteristics of GC revealed a number of features in patients >75 years compared with patients in the control group: the more frequent lesion of the distal part of stomach, the prevalence of exophytic tumor growth and the nature of low-grade histological types, the high frequency of multiple primary tumors. The rate of surgical complications and mortality in the elderly group 40,2 and 5,2%, higher than in patients >75 years old 30,9 and 2,9%. Basically, increasing the number of the surgical complications and the mortality observed after palliative surgery. Overall 5-year survival as a reference to the stage, and in the analysis depending on the type and surgical volume was significantly worse in patients >75 years old. However, specific survival analysis revealed no statistically significant differences between groups. Expansion of surgical volume in elderly patients to total gastrectomy for cancer of the stomach antrum with the transition to the body did not improve the 5-year survival. Overall survival rate after D1-1,5- and D2-lymph node dissection in patients older than 75 years old do not have significant differences.Conclusion: Gastric cancer in elderly patients does not have aggressive course and the deterioration in overall survival in old age group is mainly due to mortality from comorbidities. Improvement in overall survival in patients >75 years old extended surgical treatment have been identified.

gastric cancer, clinical and morphological characteristics, surgical treatment, and immediate and long-term results, elderly age