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	Prognosis of gastric carcinoma patients aged 85 years or older who underwent surgery or who received best supportive care only.
Journal	Formal name：International journal of clinical oncology Abbreviation：Int J Clin Oncol ISSN code：14377772/13419625
Domestic / Foregin	Domestic
Volume, Issue, Page	18(6),pp.1014-9
Author and coauthor	Endo Shunji, Dousei Tsutomu, Yoshikawa Yukinobu, Hatanaka Nobutaka, Kamiike Wataru, Nishijima Junichi
Authorship	Lead author
Publication date	2013/12
Summary	BACKGROUND:There is controversy regarding strategies for treating very elderly patients with gastric carcinoma. We aimed to assess survival after surgery in very elderly patients according to their clinical characteristics.METHODS:Gastric cancer patients aged ≥85 years were retrospectively reviewed. There were no significant differences in clinical characteristics between 58 patients with curative resection (OP group) and 32 patients with best supportive care alone (BSC group) in cancer stage IA-IIIC and with a performance status of 0-3.RESULTS:Overall survival (OS) was significantly better in the OP group than in the BSC group in females [hazard ratio (HR) 0.27, 95 % confidence interval (CI) 0.12-0.57, P < 0.001] but not in males (HR 0.71, 95 % CI 0.35-1.49, P = 0.35). OS was significantly better in the OP group in patients aged 85-89 years (HR 0.44, 95 % CI 0.25-0.78, P = 0.006) but not in patients aged ≥90 years (HR 0.47, 95 % CI 0.12-1.66, P = 0.24). OS was significantly better in the OP group in patients with stage IB-IIIC cancer (HR 0.29, 95 % CI 0.14-0.58, P < 0.001) but not in patients with stage IA cancer (HR 0.52, 95 % CI 0.21-1.27, P = 0.15).CONCLUSIONS:Females, patients aged 85-89 years, and patients with stage IB-IIIC cancer had significantly better OS with surgery than without. For males, patients aged ≥90 years, or stage IA patients, the decision to perform surgery should be carefully made, and BSC might be an optimal strategy.
DOI	10.1007/s10147-012-0482-9
PMID	23065114