Hanazaki K, Wakabayashi M, Sodeyama H, Miyazawa M, Yokoyama S, Sode Y, Kawamura N, Ohtsuka M, Miyazaki T
Department of Surgery, Nagano Red Cross Hospital, Nagano, Japan.
Hepatogastroenterology. 1998 Jan-Feb;45(19):268-75.
BACKGROUND/AIMS: Although the number of elderly patients who undergo surgery for gastric cancer has increased in recent years, the clinical features associated with this group of patients, including their postoperative survival rate, remain unclear.
The cases of 50 patients > or = 80 years of age (the older group) with gastric cancer who underwent surgical treatment in our Department from January 1988 to December 1995 were reviewed and compared to the records of 239 patients < or = 60 years of age (the younger group) who had surgery during the same time period.
The incidence of advanced gastric cancer in the older versus younger groups was 59.6% versus 27.9%, respectively (p < 0.01). The tumor size was significantly larger in the older group. The tumor location in the older group predominantly involved the upper third of the stomach, while in the younger group, the middle third of the stomach was primarily involved. Histologically, the incidence of differentiated tumor types was 65.1% versus 50.5% (p < 0.05), and undifferentiated types, 34.9% versus 49.5% (p < 0.05), in the older and younger groups, respectively. Retrospective comparisons conducted between the older and younger groups revealed the following: curative resectability rate: 52.0% versus 74.5% (p < 0.01); hospital mortality rate: 2% versus 0%; overall 5-year survival rate: 46.1% versus 71.1% (p < 0.01); and a 5-year survival rate in patients who underwent curative resection of 65.0% versus 88.8% in the older versus younger age groups, respectively.
These results suggest that the survival of elderly patients with gastric cancer is worse than that of younger patients because of a lower curative resection rate of the advanced cancer. However, the survival rate in elderly patients is identical to that in younger patients if a curative resection is performed.
背景/目的：尽管近年来接受胃癌手术的老年患者数量有所增加，但与该组患者相关的临床特征，包括其术后生存率，仍不明确。
回顾了1988年1月至1995年12月在我科接受手术治疗的50例年龄≥80岁（老年组）胃癌患者的病例，并与同期接受手术的239例年龄≤60岁（青年组）患者的记录进行比较。
老年组与青年组进展期胃癌的发生率分别为59.6%和27.9%（p<0.01）。老年组肿瘤大小明显更大。老年组肿瘤位置主要累及胃的上三分之一，而青年组主要累及胃的中三分之一。组织学上，老年组与青年组分化型肿瘤的发生率分别为65.1%和50.5%（p<0.05），未分化型分别为34.9%和49.5%（p<0.05）。老年组与青年组的回顾性比较显示：根治性切除率：52.0%对74.5%（p<0.01）；医院死亡率：2%对0%；总体5年生存率：46.1%对71.1%（p<0.01）；老年组与青年组接受根治性切除患者的5年生存率分别为65.0%和88.8%。
这些结果表明，老年胃癌患者的生存率低于青年患者，原因是进展期癌症的根治性切除率较低。然而，如果进行根治性切除，老年患者的生存率与青年患者相同。
