Sakurai Katsunobu, Muguruma Kazuya, Nagahara Hisashi, Kimura Kenjiro, Toyokawa Takahiro, Amano Ryosuke, Kubo Naoshi, Tanaka Hiroaki, Ohtani Hiroshi, Yashiro Masakazu, Maeda Kiyoshi, Ohira Masaichi, Hirakawa Kosei
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Surg Oncol. 2015 Jun;111(7):848-54. doi: 10.1002/jso.23896. Epub 2015 Mar 8.
The aim of this study was to clarify the operative mortality and long-term survival of gastrectomy for elderly patients with gastric cancer.
A total of 461 patients who underwent gastrectomy for gastric cancer in our hospital were classified as elderly group (≥80 years-old, 95 patients) and control group (60-69 years-old, 366 patients).
The frequency of comorbidities was significantly (P < 0.05) higher in elderly group (74.7%) than that in the control group (49.5%). No significant difference of the postoperative complication rate was found between the elderly group (23.2%) and the control group (23.2%). Adjuvant chemotherapy was 9.5% in the elderly group, which was significantly less than 29.0% of the control group (P < 0.05). Stage II and III elderly patients had worse disease specific survival (DSS) than controls did. In the elderly, overall survival (OS) was significantly worse than DSS in stage I patients (P < 0.05).
The operative complication rate of elderly patients was comparable to the control group. Comorbidity and occurrence of secondary malignant disease should be followed for elderly patients at stage I. For stage II and III disease patients, a novel drug which is acceptable for the elderly is needed as a postoperative therapy.
本研究旨在阐明老年胃癌患者胃切除术的手术死亡率和长期生存率。
我院共461例行胃癌胃切除术的患者被分为老年组(≥80岁,95例)和对照组(60 - 69岁,366例)。
老年组合并症的发生率(74.7%)显著高于对照组(49.5%)(P < 0.05)。老年组(23.2%)和对照组(23.2%)的术后并发症发生率无显著差异。老年组辅助化疗率为9.5%,显著低于对照组的29.0%(P < 0.05)。II期和III期老年患者的疾病特异性生存率(DSS)低于对照组。在老年患者中,I期患者的总生存率(OS)显著低于DSS(P < 0.05)。
老年患者的手术并发症发生率与对照组相当。对于I期老年患者,应关注合并症和继发性恶性疾病的发生。对于II期和III期疾病患者,需要一种老年患者可接受的新型药物作为术后治疗。