エンドウ　シュンジ   Shunji Endo   遠藤　俊治    所属   川崎医科大学  医学部 臨床医学　消化器外科学    職種   准教授
論文種別	その他
言語種別	英語
査読の有無	査読あり
表題	The comparison of prognoses between total and distal gastrectomy for gastric cancer in elderly patients ≥ 80 years old.
掲載誌名	正式名：Surgery today 略　 称：Surg Today ISSNコード：14362813/09411291
巻・号・頁	53(5),pp.569-577
著者・共著者	Shunji Endo, Tomoki Yamatsuji, Yoshinori Fujiwara, Masaharu Higashida, Hisako Kubota, Hironori Tanaka, Yoshitomo Ito, Toshimasa Okada, Kazuhiko Yoshiatsu, Tomio Ueno
発行年月	2023/05
概要	PURPOSE:In Japan, the number of distal gastrectomy for patients ≥ 80 years old is increasing, whereas that of total gastrectomy is decreasing. Surgeons seem to avoid total gastrectomy for elderly patients. Total gastrectomy is reported to have a poorer prognosis than distal gastrectomy, and postoperative pneumonia may be involved in the cause.METHODS:The medical records of 39 and 108 patients ≥ 80 years old who underwent total and distal gastrectomy, respectively, at 2 affiliated institutions between 2010 and 2019 were retrospectively reviewed. Prognoses were compared between the two groups, focusing on death from pneumonia.RESULTS:The median overall survival time after total and distal gastrectomy was 21.3 and 74.1 months, respectively, with a significantly poorer prognosis after total gastrectomy than after distal gastrectomy (p < 0.01, hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.37-3.53). The gastric cancer-specific survival time was significantly worse after total gastrectomy than after distal gastrectomy (p < 0.01, HR 2.73, 95% CI 1.29-5.79). The pneumonia-specific survival time was also significantly worse after total gastrectomy than after distal gastrectomy (p = 0.01, HR 3.44, 95% CI 1.25-9.48).CONCLUSIONS:Patients who underwent total gastrectomy had a poorer prognosis than those who underwent distal gastrectomy, because many patients died of pneumonia early after total gastrectomy.
DOI	10.1007/s00595-022-02599-0
PMID	36418575