Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Extremely High Mortality Rate after a Successful Gastrectomy for Cancer in Older Adults

  • Ciesielski, Maciej (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Kruszewski, Wieslaw Janusz (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Szajewski, Mariusz (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Walczak, Jakub (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Spychalska, Natalia (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Szefel, Jaroslaw (Department of Oncological Surgery, Gdynia Oncology Centre, Pomeranian Hospitals) ;
  • Zielinski, Jacek (Department of Oncological Surgery, Medical University of Gdansk)
  • Received : 2018.10.02
  • Accepted : 2019.04.19
  • Published : 2019.06.28
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Abstract

Purpose: Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middleterm results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. Materials and Methods: A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29-50 years (group I, n=27), 51-65 years (group II, n=117), 66-75 years (group III, n=81), and 76-92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. Results: The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. Conclusions: Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.

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