Coniglio Arianna, Tiberio Guido Alberto Massimo, Busti Monica, Gaverini Giacomo, Baiocchi Luca, Piardi Tullio, Ronconi Maurizio, Giulini Stefano Maria
Surgical Clinic, Department of Medical and Surgical Sciences, Brescia University, Brescia, Italy.
J Surg Oncol. 2004 Dec 15;88(4):201-5. doi: 10.1002/jso.20153.
The incidence of gastric cancer is increasing in the elderly. The aim of this study is to evaluate the impact of advanced age (> or =80 years) on morbidity, mortality and late outcome after curative surgery for gastric cancer.
The cases of 30 octogenarians (Group A) with gastric cancer who underwent surgical treatment in our Institution from 1990 to 2003 were reviewed and compared to a simultaneous group of 228 younger patients (Group B).
The rate of resective and curative procedures was not different in the two groups, although the American Society of Anaesthesiologists (ASA) risk was significantly higher in the elderly (P < 0.001) and the lymphatic dissection was less extended in group A. In the two groups, the curability was directly correlated to the cancer stage, but not affected by the ASA risk. The postoperative morbidity and mortality rates were similar in the two groups and were not related to the ASA risk. Considering the mortality for gastric cancer alone, the two groups showed a similar survival rate, only correlated to the cancer stage.
In the elderly, an oncologically correct surgical procedure can safely be prosecuted with satisfactory immediate and late results.
老年人群中胃癌的发病率正在上升。本研究旨在评估高龄（≥80岁）对胃癌根治性手术后的发病率、死亡率及远期预后的影响。
回顾了1990年至2003年在我院接受手术治疗的30例老年胃癌患者（A组）的病例，并与同期的228例年轻患者（B组）进行比较。
两组间切除性和根治性手术的比例无差异，尽管老年患者的美国麻醉医师协会（ASA）风险显著更高（P<0.001），且A组的淋巴结清扫范围较小。在两组中，根治性与癌症分期直接相关，但不受ASA风险的影响。两组的术后发病率和死亡率相似，且与ASA风险无关。仅考虑胃癌导致的死亡率，两组的生存率相似，仅与癌症分期相关。
对于老年患者，实施肿瘤学上正确的手术操作可安全进行，并能获得令人满意的近期和远期效果。
