Purpose: It is controversial whether the treatment strategy for gastric cancer should be different for elderly patients. We herein evaluated the feasibility of gastrectomy and the risk factors for postoperative complications in octogenarians with gastric cancer. Methods: We retrospectively collected data on 441 consecutive patients who underwent total or subtotal gastrectomy for gastric cancer. We divided all of the patients into two groups: the octogenarian group (n = 47), consisting of patients aged 80–89 years, and the younger group (n = 394), consisting of patients under 80 years of age. Results: The postoperative complication rate was 23.1 % (91/394) in the younger group and 36.2 % (17/47) in the octogenarian group (P = 0.049). Octogenarian patients had significantly lower preoperative serum albumin levels (P < 0.001) and higher ASA scores (P < 0.001). Although the rate of each major complication was similar between the two groups, there was a trend toward a higher rate of other miscellaneous complications, mostly non-surgical complications, in the octogenarian group (P = 0.077). A multivariate analysis of the patients in the octogenarian group revealed that only total gastrectomy was a significant risk factor for postoperative complications (P = 0.035). Conclusion: Octogenarian patients with gastric cancer experienced more complications than younger patients. Therefore, closer monitoring is needed for octogenarian patients who will receive total gastrectomy.
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