Short- and long-term outcomes after gastrectomy in elderly gastric cancer patients

Abstract

Background. The number of elderly patients undergoing gastric cancer surgery has recently increased. We therefore evaluated the short- and long-term outcomes of elderly patients after curative gastrectomy. Methods. Overall, 824 patients were included in this retrospective study, which comprised of a non-elderly group (60–64 years; n = 558), an early-elderly group (75– 79 years; n = 198), and a late-elderly group (C80 years; n = 68) who underwent curative gastrectomy for gastric cancer between 2005 and 2009. Postoperative complications, according to the Clavien–Dindo classification, and survival of both elderly groups were compared with the non-elderly group. Postoperative life expectancy of the late-elderly group was compared with the corresponding aged general population. Results. Overall and severe (grade III or higher) complications in the early-elderly group were comparable with the non-elderly group; however, those in the late-elderly group were significantly more common than in the non-elderly group (p = 0.013 and p = 0.043, respectively). Multivariable analysis revealed that age C80 years was an independent risk factor for severe complications (hazard ratio 3.02, 95 % confidence interval 1.12–8.17; p = 0.029), and the disease-specific survivals of both elderly groups were comparable with the non-elderly group in all TNM stages. Postoperative life expectancy of lateelderly patients eliminating death from recurrence was comparable with the corresponding aged general population eliminating death from gastric cancer. Conclusions. Gastric cancer surgery in elderly patients aged C80 years achieves reasonable long-term survival despite the increased risk of severe complications.