Endo Shunji, Yoshikawa Yukinobu, Hatanaka Nobutaka, Dousei Tsutomu, Yamada Terumasa, Nishijima Junichi, Kamiike Wataru
1 Department of Surgery, National Hospital Organization Kure Medical Center/Chugoku Cancer Center, Hiroshima, Japan.
Int Surg. 2014 Mar-Apr;99(2):166-73. doi: 10.9738/INTSURG-D-13-00016.1.
The decision to undergo surgery for gastric cancer patients aged ≥85 years should be made carefully. We retrospectively reviewed the prognostic factors of gastrectomy for 64 patients aged ≥85 years who had undergone curative gastrectomy for gastric cancer. The effects of various clinical characteristics and surgical interventions on survival were retrospectively analyzed. Univariate analysis revealed that sex (male/female; P = 0.001), the extent of gastric resection (total/distal; P = 0.028), the extent of lymph node dissection (D2/<D2; P = 0.019), and blood loss (P = 0.005) were significant prognostic factors for overall survival. Multivariate analysis demonstrated that sex was the only independent prognostic factor. For pneumonia-specific survival, sex was also the only prognostic factor by multivariate analysis.Prognoses of males aged ≥85 years after gastrectomy were significantly worse than those of females, as they were more likely to die of pneumonia.
对于年龄≥85岁的胃癌患者,决定是否接受手术应谨慎。我们回顾性分析了64例年龄≥85岁、因胃癌接受根治性胃切除术患者的胃切除预后因素。回顾性分析了各种临床特征和手术干预对生存的影响。单因素分析显示,性别(男/女;P = 0.001)、胃切除范围(全胃/远端胃;P = 0.028)、淋巴结清扫范围(D2/<D2;P = 0.019)和失血量(P = 0.005)是总生存的显著预后因素。多因素分析表明,性别是唯一的独立预后因素。对于特定于肺炎的生存,多因素分析显示性别也是唯一的预后因素。年龄≥85岁男性胃切除术后的预后明显比女性差,因为他们更可能死于肺炎。