Shunji Endo
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of Digestive Surgery,
   Position   Associate Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Treatment for gastric carcinoma in the oldest old patients.
Journal Formal name：Gastric cancer
Abbreviation：Gastric Cancer
ISSN code：14363305/14363291
Domestic / ForeginDomestic
Volume, Issue, Page 14(2),pp.139-43
Author and coauthor Endo Shunji, Yoshikawa Yukinobu, Hatanaka Nobutaka, Tominaga Harumi, Shimizu Yosuke, Hiraoka Kazuya, Nishitani Akiko, Irei Toshimitsu, Nakashima Shinsuke, Park Mi-Hwa, Takahashi Hiroyo, Wakahara Makoto, Kamiike Wataru
Authorship Lead author
Publication date 2011/06
Summary BACKGROUND:The strategy for treating extremely aged patients with gastric carcinoma is controversial. This study reviews the prognoses of patients aged 85 years and older who were diagnosed with gastric carcinoma.METHODS:One hundred seventeen patients aged 85 years and older were diagnosed as having gastric carcinoma after 1969 in our institution. After excluding those at stage IV, 36 cases underwent curative resection and 30 cases received best supportive care (BSC), which we reviewed retrospectively.RESULTS:Surgical methods included distal gastrectomy for 28 cases, total gastrectomy for five cases, and other procedures for three cases. Postoperatively, pneumonia developed in four cases, anastomotic leakage in two cases, and pancreatic fistula in one case. Two patients died of pneumonia within 1 month of surgery. Univariate analysis demonstrated that age, surgery, performance status, and sodium level were statistically significant prognostic factors. Multivariate analysis demonstrated that surgery was the only independent prognostic factor. When patients with a performance status of 4 were excluded, the clinical characteristics of the surgery group (n = 36) and BSC group (n = 20) were statistically identical, and the overall survival was significantly better in the surgery group (p = 0.0078).CONCLUSIONS:Postoperative outcomes were relatively acceptable. Surgery may be feasible and beneficial even for extremely aged patients 85 years and older, except for those with a performance status of 4.
DOI 10.1007/s10120-011-0022-8
PMID 21336856