Takabatake Kazuya, Sakuramoto Shinichi, Kobayashi Ryota, Toriumi Tetsuro, Ebara Gen, Li Seigi, Miyawaki Yutaka, Sato Hiroshi, Yamashita Keishi
Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan;
Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
In Vivo. 2025 Jan-Feb;39(1):419-425. doi: 10.21873/invivo.13844.
BACKGROUND/AIM: The effect of left ventricular systolic dysfunction (LVSD), a risk factor for postoperative mortality, in older adult patients with gastric cancer has not been fully elucidated. This study aimed to evaluate the impact of low preoperative left ventricular ejection fraction (EF) on short- and long-term outcomes in older adult patients with gastric cancer.
This retrospective study enrolled 237 older adult patients with gastric cancer (≥75 years old) who underwent preoperative echocardiography and curative gastrectomy. LVSD was defined as an EF <50%. Postoperative complications and prognosis were compared between patients with low- and normal-EF using the Fisher's exact or Chi-square test, log-rank test, Kaplan-Meier method, and Cox regression analysis.
Thirteen patients (5.4%) exhibited LVSD. The incidence of postoperative complications was not significantly different between the two groups (p=0.470), although the incidence of pneumonia was high (p=0.003) and overall survival was significantly worse in the low-EF group compared to the normal-EF group (p=0.016). Multivariate analysis revealed that decreased EF, low preoperative body mass index, and advanced pathological stage were significant prognostic factors in older adult patients with gastric cancer.
LVSD increases the risk of postoperative pneumonia and has a negative prognostic impact on older adult patients with gastric cancer.
背景/目的：左心室收缩功能障碍（LVSD）作为术后死亡的一个危险因素，在老年胃癌患者中的影响尚未完全阐明。本研究旨在评估术前低左心室射血分数（EF）对老年胃癌患者短期和长期预后的影响。
这项回顾性研究纳入了237例接受术前超声心动图检查和根治性胃切除术的老年胃癌患者（≥75岁）。LVSD定义为EF<50%。采用Fisher精确检验或卡方检验、对数秩检验、Kaplan-Meier法和Cox回归分析比较低EF组和正常EF组患者的术后并发症及预后情况。
13例患者（5.4%）表现出LVSD。两组术后并发症的发生率无显著差异（p=0.470），尽管肺炎的发生率较高（p=0.003），且低EF组的总生存期明显比正常EF组差（p=0.016）。多因素分析显示，EF降低、术前低体重指数和晚期病理分期是老年胃癌患者的重要预后因素。
LVSD增加了术后肺炎的风险，并对老年胃癌患者的预后产生负面影响。
