Choo Jin Woo, Ju Yeonmi, Lim Hyun, Youn Sung Hee, Soh Jae Seung, Park Ji Won, Kang Ho Suk, Kim Sung Eun, Moon Sung Hoon, Kim Jong Hyeok, Park Choong Kee, Ha Hong Il, Kim Min-Jeong, Kim Kab-Choong, Cho Ji Woong
a Department of Internal Medicine , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea.
b Department of Radiology , University of Hallym College of Medicine, Hallym University Sacred Heart Hospital , Anyang , Republic of Korea.
Scand J Gastroenterol. 2017 Oct;52(10):1057-1064. doi: 10.1080/00365521.2017.1339828. Epub 2017 Jun 22.
With the aging population, the number of elderly patients diagnosed with gastric cancer is increasing. However, determining treatment strategies for elderly patients with gastric cancer is controversial. The aim of this study is to evaluate the usefulness of surgical treatment on elderly patients aged ≥80 years with advanced gastric cancer.
A total of 147 elderly patients who were diagnosed with advanced gastric cancer from August 2001 to December 2015 were retrospectively analyzed. We compared the clinicopathological features and prognoses of 94 elderly patients (80-85 years) and 53 extreme-elderly patients (≥86 years) according to treatment modalities.
In the elderly group, the 3-year overall survival (OS) rates of the surgical resection group and supportive care group were 42.1% and 4.0%, respectively (p < .001). In the extreme-elderly group, the 3-year OS rates of the surgical resection group and supportive care group were 36.4% and 8.0%, respectively (p = .028). The post-operative mortality rate of the elderly group and extreme-elderly group was 5.6% and 9.1%, respectively. In the analysis of risk factors associated with survival, surgical resection was a significantly good prognostic factor in the elderly group (hazard ratio [HR] = 0.277; p = .003) compared with supportive care. In the extreme-elderly group, surgical resection was associated with good prognosis but did not reach statistical significance (HR = 0.491; p = .099).
These results suggest that elderly patients aged 80-85 years with advanced gastric cancer could expect a better prognosis with surgical resection. However, extreme-elderly patients aged ≥86 years should consider the risks and benefits of surgical treatment.
随着人口老龄化，被诊断为胃癌的老年患者数量不断增加。然而，确定老年胃癌患者的治疗策略存在争议。本研究的目的是评估手术治疗对年龄≥80岁的老年晚期胃癌患者的有效性。
回顾性分析2001年8月至2015年12月期间共147例被诊断为晚期胃癌的老年患者。我们根据治疗方式比较了94例老年患者（80 - 85岁）和53例高龄老年患者（≥86岁）的临床病理特征和预后。
在老年组中，手术切除组和支持治疗组的3年总生存率（OS）分别为42.1%和4.0%（p < 0.001）。在高龄老年组中，手术切除组和支持治疗组的3年OS率分别为36.4%和8.0%（p = 0.028）。老年组和高龄老年组的术后死亡率分别为5.6%和9.1%。在生存相关危险因素分析中，与支持治疗相比，手术切除在老年组中是显著良好的预后因素（风险比[HR] = 0.277；p = 0.003）。在高龄老年组中，手术切除与良好预后相关，但未达到统计学意义（HR = 0.491；p = 0.099）。
这些结果表明，80 - 85岁的老年晚期胃癌患者手术切除有望获得更好的预后。然而，≥86岁的高龄老年患者应考虑手术治疗的风险和益处。
