Evaluation of treatment strategies for gastric cancer in the elderly according to the number of abnormal parameters on preoperative examination

The treatment strategies in patients with gastric cancer aged 80 years or older have not yet been well defined. We examined the incidence of postoperative complications and hospital mortality regarding the preoperative condition of such patients. A preoperative examination included evaluations of th...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 1999-01, Vol.29 (9), p.837-841
Main Authors: Hara, H, Isozaki, H, Nomura, E, Fujii, K, Sako, S, Tanigawa, N
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Aged, 80 and over
Case-Control Studies
Digestive System Surgical Procedures
Health Status
Hospital Mortality
Humans
Incidence
Middle Aged
Postoperative Complications - epidemiology
Preoperative Care
Stomach Neoplasms - diagnosis
Stomach Neoplasms - mortality
Stomach Neoplasms - surgery
Survival Rate
Time Factors
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Summary:The treatment strategies in patients with gastric cancer aged 80 years or older have not yet been well defined. We examined the incidence of postoperative complications and hospital mortality regarding the preoperative condition of such patients. A preoperative examination included evaluations of the cardiac, pulmonary, renal, and hepatic functions, the presence or absence of anemia, nutritional status, and blood sugar content. The incidence of postoperative complications and hospital mortality were then studied in relation to the number of preoperative abnormal parameters. The incidence of postoperative complications was 37.0%. The rate of hospital mortality was 11.1%. Among the patients with abnormalities in five or more items, the incidence of complications was 76.9% and the rate of hospital mortality was 23.1%. In the patients with an operative time of 4 h or longer, the same incidence was 71.4%. Among the patients who underwent a curative resection, the 5-year survival rate was 92.3%. For elderly gastric cancer patients with abnormalities in five or more items during a preoperative examination and for those showing a poor level of daily life activity, a less invasive treatment modality should be planned. Patients with abnormalities of four or fewer items at a preoperative examination appear to be good candidates for curative resection.
ISSN:0941-1291
1436-2813
DOI:10.1007/bf02482772