Li Yong, Tan Bibo, Fan Liqiao, Zhao Qun, Tan Ming, Wang Dong, Jia Nan, Liu Qingwei
a Department of General Surgery , the Fourth Affiliated Hospital, Hebei Medical University , Shijiazhuang , P.R. China.
J Invest Surg. 2017 Dec;30(6):394-400. doi: 10.1080/08941939.2016.1265617. Epub 2017 Jan 3.
In China, gastric cancer (GC), which is one of the most common malignant tumors, has an increasing incidence in elderly population due to aging process. Since a considerable number of elderly patients with GC accepting surgical treatments developed postoperative complications, it is necessary to evaluate risk factors for postoperative complications.
In the present study, the clinicopathologic characteristics of 3,024 elderly patients (aged ≥65 years) with GC, who underwent surgery between 1996 and 2006, were examined and contributing factors for postoperative complications were analyzed. A total of 2,915 non-elderly patients (aged <65 years) with GC during the same period were enrolled as a control group. Clinicopathologic characteristics of non-elderly patients were investigated and compared with elderly group.
As to clinicopathologic characteristics, significant differences were detected in terms of location of primary lesions between elderly patients and non-elderly patients (p <.05), whereas no statistical difference was observed in other characteristics between two groups (p >.05). Surgical property and method in elderly patients were similar to that in non-elderly patients (p >.05). Regression analysis showed that diabetes, chronic pulmonary disease, preoperative anemia, preoperative hypoalbuminemia, combined organ excision, and blood transfusion were independent factors for complications in elderly patients (p <.05), with some differences from non-elderly group.
Elderly group with GC had distinctive clinicopathologic characteristics. Surgery remains principal treatment for elderly, and proper preoperative measures are required to decrease postoperative complications.
在中国，胃癌（GC）是最常见的恶性肿瘤之一，随着老龄化进程，老年人群中的发病率呈上升趋势。由于相当数量接受手术治疗的老年GC患者出现了术后并发症，因此有必要评估术后并发症的危险因素。
在本研究中，对1996年至2006年间接受手术的3024例老年GC患者（年龄≥65岁）的临床病理特征进行了检查，并分析了术后并发症的相关因素。同期共纳入2915例非老年GC患者（年龄<65岁）作为对照组。对非老年患者的临床病理特征进行了调查，并与老年组进行了比较。
在临床病理特征方面，老年患者与非老年患者在原发灶位置上存在显著差异（p<.05），而两组在其他特征上未观察到统计学差异（p>.05）。老年患者的手术性质和方法与非老年患者相似（p>.05）。回归分析表明，糖尿病、慢性肺病、术前贫血、术前低白蛋白血症、联合器官切除和输血是老年患者并发症的独立因素（p<.05），与非老年组存在一些差异。
老年GC组具有独特的临床病理特征。手术仍然是老年患者的主要治疗方法，需要采取适当的术前措施以减少术后并发症。
