Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Outcomes of Gastrectomy for Gastric Cancer in Patients Aged >80 Years: A Systematic Literature Review and Meta-Analysis

  • Zelalem Chimdesa Merga (Department of General Surgery, Zewditu Memorial Hospital) ;
  • Ji Sung Lee (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chung-Sik Gong (Division of Gastrointestinal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.04.11
  • Accepted : 2023.05.09
  • Published : 2023.07.31
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Abstract

This meta-analysis examined the surgical management of older patients (>80 years) with gastric cancer, who were often excluded from randomized controlled trials. We analyzed 23 retrospective cohort studies involving 18,372 patients and found that older patients had a higher in-hospital mortality rate (relative risk [RR], 3.23; 95% confidence interval [CI], 1.46-7.17; P<0.01) and more post-operative complications (RR, 1.36; 95% CI, 1.19-1.56; P<0.01) than did younger patients. However, the surgical complications were similar between the two groups. Older patients were more likely to undergo less extensive lymph node dissection and longer hospital stays. Although older patients had statistically significant post-operative medical complications, they were not deprived of surgery for gastric cancer. The comorbidities and potential risks of post-operative complications should be carefully evaluated in older patients, highlighting the importance of careful patient selection. Overall, this meta-analysis provides recommendations for the surgical management of older patients with gastric cancer. Careful patient selection and evaluation of comorbidities should be performed to minimize the risk of post-operative complications in older patients, while recognizing that they should not be deprived of surgery for gastric cancer.

Keywords

Acknowledgement

We express our sincere gratitude to Drs. Birkneh Tilahun Tadesse and Alessandro Parente for their invaluable contributions to our meta-analysis by providing invaluable ideas, insights, and encouragement throughout the analysis, which were instrumental in shaping the direction of our work and ensuring its success. We are fortunate to have had the opportunity to work with such conversant colleagues, and we acknowledge them unreservedly for their assistance.

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