Postoperative Long-Term Outcomes in Elderly Patients with Gastric Cancer and Risk Factors for Death from Other Diseases

Tadayoshi Hashimoto, Yukinori Kurokawa, Jota Mikami, Tsuyoshi Takahashi, Yasuhiro Miyazaki, Koji Tanaka, Tomoki Makino, Makoto Yamasaki, Masaaki Motoori, Yutaka Kimura, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

Abstract

Background: Elderly patients with gastric cancer are frequently treated surgically in current clinical practice. Although several studies have investigated short-term outcomes after gastrectomy in elderly patients, most did not evaluate long-term outcomes. Methods: We analyzed 1154 consecutive patients who underwent curative gastrectomy for gastric cancer between 2001 and 2013. We classified them into two groups: the elderly group (n = 241), consisting of patients aged ≥75 years, and the non-elderly group (n = 913), consisting of patients aged <75 years, and compared the short- and long-term outcomes between the two groups. The risk factors for death from other diseases in elderly patients were also examined. Results: Although the incidence of postoperative pneumonia was significantly higher in the elderly group (P < 0.001), the proportion of overall postoperative complications did not differ significantly between the two groups (P = 0.097). The disease-specific survival was similar between the two groups (P = 0.743), whereas the overall survival in the elderly group was significantly shorter than that in the non-elderly group (P < 0.001) because of a higher incidence of death from other diseases throughout all gastric cancer stages. Multivariate analysis revealed that a low preoperative prognostic nutrition index (PNI) and multiple comorbidities were significant risk factors for death from other diseases within 5 years in the elderly group. Conclusions: Despite acceptable short-term outcomes, long-term outcomes in elderly patients with gastric cancer were poor due to the high incidence of death from other diseases. Indications for surgery in elderly patients with a low PNI or multiple comorbidities should be considered carefully.

Original languageEnglish
Pages (from-to)2885-2893
Number of pages9
JournalWorld journal of surgery
Volume43
Issue number11
DOIs
Publication statusPublished - Nov 1 2019

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Stomach Neoplasms
Nutrition Assessment
Gastrectomy
Comorbidity
Incidence
Survival
Pneumonia
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Hashimoto, T., Kurokawa, Y., Mikami, J., Takahashi, T., Miyazaki, Y., Tanaka, K., ... Doki, Y. (2019). Postoperative Long-Term Outcomes in Elderly Patients with Gastric Cancer and Risk Factors for Death from Other Diseases. World journal of surgery, 43(11), 2885-2893. https://doi.org/10.1007/s00268-019-05109-5

Postoperative Long-Term Outcomes in Elderly Patients with Gastric Cancer and Risk Factors for Death from Other Diseases. / Hashimoto, Tadayoshi; Kurokawa, Yukinori; Mikami, Jota; Takahashi, Tsuyoshi; Miyazaki, Yasuhiro; Tanaka, Koji; Makino, Tomoki; Yamasaki, Makoto; Motoori, Masaaki; Kimura, Yutaka; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro.

In: World journal of surgery, Vol. 43, No. 11, 01.11.2019, p. 2885-2893.

Research output: Contribution to journalArticle

Hashimoto, T, Kurokawa, Y, Mikami, J, Takahashi, T, Miyazaki, Y, Tanaka, K, Makino, T, Yamasaki, M, Motoori, M, Kimura, Y, Nakajima, K, Mori, M & Doki, Y 2019, 'Postoperative Long-Term Outcomes in Elderly Patients with Gastric Cancer and Risk Factors for Death from Other Diseases', World journal of surgery, vol. 43, no. 11, pp. 2885-2893. https://doi.org/10.1007/s00268-019-05109-5
Hashimoto, Tadayoshi ; Kurokawa, Yukinori ; Mikami, Jota ; Takahashi, Tsuyoshi ; Miyazaki, Yasuhiro ; Tanaka, Koji ; Makino, Tomoki ; Yamasaki, Makoto ; Motoori, Masaaki ; Kimura, Yutaka ; Nakajima, Kiyokazu ; Mori, Masaki ; Doki, Yuichiro. / Postoperative Long-Term Outcomes in Elderly Patients with Gastric Cancer and Risk Factors for Death from Other Diseases. In: World journal of surgery. 2019 ; Vol. 43, No. 11. pp. 2885-2893.
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AU - Hashimoto, Tadayoshi

AU - Kurokawa, Yukinori

AU - Mikami, Jota

AU - Takahashi, Tsuyoshi

AU - Miyazaki, Yasuhiro

AU - Tanaka, Koji

AU - Makino, Tomoki

AU - Yamasaki, Makoto

AU - Motoori, Masaaki

AU - Kimura, Yutaka

AU - Nakajima, Kiyokazu

AU - Mori, Masaki

AU - Doki, Yuichiro

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N2 - Background: Elderly patients with gastric cancer are frequently treated surgically in current clinical practice. Although several studies have investigated short-term outcomes after gastrectomy in elderly patients, most did not evaluate long-term outcomes. Methods: We analyzed 1154 consecutive patients who underwent curative gastrectomy for gastric cancer between 2001 and 2013. We classified them into two groups: the elderly group (n = 241), consisting of patients aged ≥75 years, and the non-elderly group (n = 913), consisting of patients aged <75 years, and compared the short- and long-term outcomes between the two groups. The risk factors for death from other diseases in elderly patients were also examined. Results: Although the incidence of postoperative pneumonia was significantly higher in the elderly group (P < 0.001), the proportion of overall postoperative complications did not differ significantly between the two groups (P = 0.097). The disease-specific survival was similar between the two groups (P = 0.743), whereas the overall survival in the elderly group was significantly shorter than that in the non-elderly group (P < 0.001) because of a higher incidence of death from other diseases throughout all gastric cancer stages. Multivariate analysis revealed that a low preoperative prognostic nutrition index (PNI) and multiple comorbidities were significant risk factors for death from other diseases within 5 years in the elderly group. Conclusions: Despite acceptable short-term outcomes, long-term outcomes in elderly patients with gastric cancer were poor due to the high incidence of death from other diseases. Indications for surgery in elderly patients with a low PNI or multiple comorbidities should be considered carefully.

AB - Background: Elderly patients with gastric cancer are frequently treated surgically in current clinical practice. Although several studies have investigated short-term outcomes after gastrectomy in elderly patients, most did not evaluate long-term outcomes. Methods: We analyzed 1154 consecutive patients who underwent curative gastrectomy for gastric cancer between 2001 and 2013. We classified them into two groups: the elderly group (n = 241), consisting of patients aged ≥75 years, and the non-elderly group (n = 913), consisting of patients aged <75 years, and compared the short- and long-term outcomes between the two groups. The risk factors for death from other diseases in elderly patients were also examined. Results: Although the incidence of postoperative pneumonia was significantly higher in the elderly group (P < 0.001), the proportion of overall postoperative complications did not differ significantly between the two groups (P = 0.097). The disease-specific survival was similar between the two groups (P = 0.743), whereas the overall survival in the elderly group was significantly shorter than that in the non-elderly group (P < 0.001) because of a higher incidence of death from other diseases throughout all gastric cancer stages. Multivariate analysis revealed that a low preoperative prognostic nutrition index (PNI) and multiple comorbidities were significant risk factors for death from other diseases within 5 years in the elderly group. Conclusions: Despite acceptable short-term outcomes, long-term outcomes in elderly patients with gastric cancer were poor due to the high incidence of death from other diseases. Indications for surgery in elderly patients with a low PNI or multiple comorbidities should be considered carefully.

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