Ishigami S, Natsugoe S, Hokita S, Iwashige H, Saihara T, Tokushige M, Aikou T
First Department of Surgery, Kagoshima University School of Medicine, Japan.
Hepatogastroenterology. 1999 May-Jun;46(27):2091-5.
BACKGROUND/AIMS: There is little information about the clinical and pathological features of patients with gastric cancer aged 85 years old and older.
We analyzed data of 197 gastric cancer patients aged 75 years and older. The patients were dividing into three age groups and we retrospectively studied 25 gastric cancer patients aged 85 years old and older and compared their clinical courses with those of 94 patients in their late 70s and 78 patients in their early 80s.
The patients aged 85 years and older had a significantly higher rate of symptoms on admission such as gastric outlet obstruction and progressive anemia (64%), than did the other two age groups (p<0.05). Twenty-five percent of the oldest age group did not have surgery, and none had a D2 lymph node dissection. Perioperative complications were more frequent in the oldest group than in the youngest group (p<0.05). Survival in the oldest patients was not affected by surgical resection.
These results indicate curative gastric surgery has a less positive impact in patients aged 85 years and older than younger patients. Treatment for gastric cancer in patients 85 years old and older should emphasize the palliation of symptoms but not curative resection.
背景/目的：关于85岁及以上老年胃癌患者的临床和病理特征的信息较少。
我们分析了197例75岁及以上胃癌患者的数据。将患者分为三个年龄组，回顾性研究了25例85岁及以上的胃癌患者，并将他们的临床病程与94例70多岁晚期患者和78例80岁出头患者的临床病程进行比较。
85岁及以上患者入院时出现胃出口梗阻和进行性贫血等症状的比例（64%）显著高于其他两个年龄组（p<0.05）。最年长年龄组中有25%的患者未接受手术，且无一例进行D2淋巴结清扫。围手术期并发症在最年长组比最年轻组更常见（p<0.05）。最年长患者的生存不受手术切除的影响。
这些结果表明，与年轻患者相比，根治性胃手术对85岁及以上患者的积极影响较小。85岁及以上胃癌患者的治疗应强调症状缓解而非根治性切除。
