| The Road to Curative Surgery in Gastric Cancer Treatment: A Different Path in the Elderly? | |
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MedLine Citation:
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PMID: 23036827 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The aim of this study was to evaluate the possibility of a different path to achieve curative surgery in patients older than age 70 years and affected by resectable gastric cancer. STUDY DESIGN: This is a multicentric retrospective study based on an analysis of 1,465 patients with gastric adenocarcinoma who underwent surgery with curative intent. Patients were divided into 2 age groups (younger than 70 years vs older than 70 years) and were evaluated with respect to postoperative morbidity and mortality and survival. RESULTS: Postoperative morbidity and mortality in elderly and nonelderly groups were 24.8% vs 20.6% and 2.6% vs 3.7%, respectively (p = NS). In the elderly group, multivisceral resection was independently associated with surgical complications (hazard ratio [HR] = 1.988; 95% CI, 1.124-3.516; p = 0.018), total gastrectomy with medical complications (HR = 2.007; 95% CI, 1.165-3.459; p = 0.012), and higher postoperative mortality (HR = 4.319; 95% CI, 1.571-11.873; p = 0.005); D1 lymph node dissection was predictive of a lower postoperative mortality rate (HR = 0.219; 95% CI, 0.080-0.603; p = 0.003). Five-year overall survival rates differed significantly in young and elderly patients (58.9% vs 38.9%; p < 0.001), and 5-year cancer-specific survival did not show any significant difference. CONCLUSIONS: Age should not be considered as a factor in the selection of treatment for gastric cancer patients. Curative surgery can be performed as safely in elderly patients as in younger patients, with comparable postoperative results and long-term survival rates, although the life expectancy of elderly patients is shorter. |
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Authors:
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Alberto Biondi; Ferdinando C M Cananzi; Roberto Persiani; Valerio Papa; Maurizio Degiuli; Giovanni Battista Doglietto; Domenico D'Ugo |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-1 |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: - ISSN: 1879-1190 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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General Surgery Unit, Department of Surgery, "A. Gemelli" University Hospital, Catholic University of Rome, Rome. Electronic address: biondi.alberto@tiscali.it. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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