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- Title
Prognostic factors for elderly gastric cancer patients who underwent gastrectomy.
- Authors
Endo, Shunji; Yamatsuji, Tomoki; Fujiwara, Yoshinori; Higashida, Masaharu; Kubota, Hisako; Matsumoto, Hideo; Tanaka, Hironori; Okada, Toshimasa; Yoshimatsu, Kazuhiko; Sugimoto, Ken; Ueno, Tomio
- Abstract
Background: Patients with gastric cancer are aging in Japan. It is not clear which patients and which surgical procedures have survival benefits after gastrectomy. A multivariate analysis was performed. Methods: The medical records of 166 patients aged ≥ 80 years who underwent gastrectomy without macroscopic residual tumors were retrospectively reviewed. Univariate and multivariate analyses using Cox proportional hazard models were performed to detect prognostic factors for overall survival. Results: In univariate analyses, age (≥ 90 vs. ≥ 80, < 85), performance status (3 vs. 0), American Society of Anesthesiologists physical status (ASA-PS) (3, 4 vs. 1, 2), Onodera's prognostic nutritional index (< 40 vs. ≥ 45), the physiological score of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) (≥ 40 vs. ≥ 20, ≤ 29), surgical approach (laparoscopic vs. open), extent of gastrectomy (total, proximal vs. distal), extent of lymphadenectomy (D1 vs. ≥ D2), pathological stage (II–IV vs. I), and residual tumor (R1 vs. R0) were significantly correlated with worse overall survival. Multivariate analysis revealed that ASA-PS [3, 4 vs. 1, 2, hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.24–4.24], extent of gastrectomy (total vs. distal, HR 2.17, 95% CI 1.10–4.31) (proximal vs. distal, HR 4.05, 95% CI 1.45–11.3), extent of lymphadenectomy (D0 vs. ≥ D2, HR 12.4, 95% CI 1.58–97.7), and pathological stage were independent risk factors for mortality. Conclusions: ASA-PS was a useful predictor for postoperative mortality. Gastrectomy including cardia is best avoided.
- Subjects
JAPAN; LYMPHADENECTOMY; PROGNOSIS; STOMACH cancer; GASTRECTOMY; PROPORTIONAL hazards models; CANCER patients
- Publication
World Journal of Surgical Oncology, 2022, Vol 20, Issue 1, p1
- ISSN
1477-7819
- Publication type
Article
- DOI
10.1186/s12957-021-02475-0