Oya Hisaharu, Komatsu Yoshinao, Shimizu Dai, Koike Shinya, Tagami Koichiro, Kodera Yasuhiro
Hepatogastroenterology. 2013 Oct;60(127):1673-80.
BACKGROUND/AIMS: The aim of this study was to identify the factors influencing mortality, morbidity and survival for gastric cancer in patients 80 years of age and older.
This retrospective study of gastric cancer in the elderly was conducted from 2003 to 2008. We examined demographic data, treatment, causes of death and their overall survival.
On gastric cancer in the elderly, the stage IV was significantly higher in non-surgery group (47%) than in surgery group (12%). Moreover, non-surgery group had significantly more cardiac disease (p = 0.007) and previous stroke (p = 0.035) than surgery group. Differences in overall survival were statistically significant among stage I (p = 0.025) and stage II/III (p <0.001) patients. The other, the overall survival difference was not statistically significant between surgery group and non-surgery group, in stage IV (p = 0.05).
In the study, age is not the only contraindication to resection for gastric cancer because when elderly patients undergo curative resection, they do not have a worse prognosis than without surgery group. In the elderly, the surgical strategy must be always modulated on the basis of preoperative comorbidities, the degree of the tumor spread, and the expected equality of life offered by a surgical procedure.
背景/目的：本研究旨在确定影响80岁及以上胃癌患者死亡率、发病率和生存率的因素。
本研究对2003年至2008年期间的老年胃癌患者进行了回顾性研究。我们检查了人口统计学数据、治疗情况、死亡原因及其总体生存率。
在老年胃癌患者中，非手术组的IV期比例（47%）显著高于手术组（12%）。此外，非手术组的心脏病（p = 0.007）和既往中风（p = 0.035）明显多于手术组。I期（p = 0.025）和II/III期（p <0.001）患者的总体生存率差异具有统计学意义。另外，IV期患者手术组和非手术组的总体生存率差异无统计学意义（p = 0.05）。
在本研究中，年龄并非胃癌切除术的唯一禁忌证，因为老年患者接受根治性切除术后，其预后并不比未手术组差。对于老年患者，手术策略必须始终根据术前合并症、肿瘤扩散程度以及手术预期的生活质量进行调整。
