Fujiwara Shozo, Noguchi Tsuyoshi, Harada Katsuhisa, Noguchi Takuya, Wada Shinsuke, Moriyama Hatsuo
Department of Gastrointestinal Surgery, Oita University, Oita, Japan.
Hepatogastroenterology. 2012 Mar-Apr;59(114):620-2. doi: 10.5754/hge10269.
BACKGROUND/AIMS: We aimed to clarify the clinicopathological features of gastric cancer in very elderly patients and to identify appropriate surgical therapy for them, focused particularly on their prognosis.
Patients who underwent gastrectomy for gastric cancer in Oita University Hospital were included in this study. The patients were divided into two groups: the very elderly group (80 years or older) (E group) and the middle-aged group (ranging from 40 to 79 years) (M group). Their clinicopathological features and postoperative survival were compared.
Type 3,4 macroscopic types, INFγ and number of dissected lymph nodes were significantly less in the E group than in the M group (p=0.0092, p=0.0077, p=0.0475, respectively). Overall survival and disease-free survival were shorter for the E group (p=0.0898, p=0.0566, respectively). When other cause-related deaths were considered to be lost to follow-up, there was no significant difference between the E group and the M group.
Whenever radical resection is possible, surgical resection for gastric cancer, even in the very elderly, should not be denied. Nevertheless, surgeons should try to do less invasive surgery, especially for the very elderly.
背景/目的：我们旨在阐明高龄胃癌患者的临床病理特征，并确定适合他们的手术治疗方法，尤其关注其预后情况。
本研究纳入了在大分大学医院接受胃癌胃切除术的患者。患者被分为两组：高龄组（80岁及以上）（E组）和中年组（40至79岁）（M组）。比较两组患者的临床病理特征及术后生存率。
E组的3、4型大体类型、INFγ及清扫淋巴结数量显著少于M组（分别为p = 0.0092、p = 0.0077、p = 0.0475）。E组的总生存期和无病生存期较短（分别为p = 0.0898、p = 0.0566）。若将其他原因导致的死亡视为失访，则E组和M组之间无显著差异。
只要有可能进行根治性切除，即使是高龄患者，胃癌的手术切除也不应被拒绝。然而，外科医生应尽量进行微创性手术，尤其是对高龄患者。
