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Purpose <p>This study aimed to investigate the safety of gastrectomy for gastric cancer in oldest-old patients aged ≥ 85&#xa0;years.</p> Methods <p>This study retrospectively analyzed the patients aged ≥ 85&#xa0;years who diagnosed with gastric cancer between 2008 and 2022. The study patients were divided into three groups: a surgery group, an endoscopic submucosal dissection (ESD) group, and a non-surgery and non-ESD group (n = 64, 57, and 152). Surgical outcomes and 3-year overall and recurrence-free survival (OS and RFS) were investigated.</p> Results <p>In the surgery group, the study cohort comprised 30 males and 34 females with a median age of 87&#xa0;years. Distal, proximal, and total gastrectomy (DG, PG, and TG) were performed in 54, 1, and 9 patients, respectively. There were 27, 16, 17, and 4 patients with pStage I, II, III, and IV, respectively. Thirty-day morbidity with Clavien-Dindo grade ≥ 3 and 30-day mortality were 12.5% and 3.1%, respectively. Kaplan–Meier curves for the 3-year OS and RFS demonstrated that survival curves worsened with increasing pStage (<i>p</i> = 0.005 and <i>p</i> &lt; 0.001, respectively). In multivariate analyses for the 3-year OS and RFS, TG and pStage ≥ III were independent risk factors (<i>p</i> = 0.028 and 0.011 in OS, <i>p</i> = 0.021 and 0.001 in RFS). In comparisons of 3-year OSs among the three groups in each cStage, survivals in the surgery group were consistently better than those in the non-surgery and non-ESD group in cStages I to III (<i>p</i> &lt; 0.001, 0.001, and &lt; 0.001 in cStage I, II, and III, respectively).</p> Conclusion <p>Our findings suggest that the radical gastrectomy for gastric cancer can be performed safely and has a chance to improve survival even in the oldest-old patients aged ≥ 85&#xa0;years.</p>

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Current Status of Gastrectomy for Gastric Cancer in Oldest-old Patients Aged 85 Years or Older

  • 期刊论文

  • 发表日期：

    2025年3月22日

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  • Kazuaki Matsui,
  • Yoshiki Kawaguchi,
  • Takahiro Iwai,
  • Yukiko Torizaki,
  • Yoko Adachi,
  • Hirofumi Shimoda,
  • Takehiro Shimada,
  • Yasuhito Sekimoto,
  • Hidejiro Urakami,
  • Shiko Seki

摘要

Purpose

This study aimed to investigate the safety of gastrectomy for gastric cancer in oldest-old patients aged ≥ 85 years.

Methods

This study retrospectively analyzed the patients aged ≥ 85 years who diagnosed with gastric cancer between 2008 and 2022. The study patients were divided into three groups: a surgery group, an endoscopic submucosal dissection (ESD) group, and a non-surgery and non-ESD group (n = 64, 57, and 152). Surgical outcomes and 3-year overall and recurrence-free survival (OS and RFS) were investigated.

Results

In the surgery group, the study cohort comprised 30 males and 34 females with a median age of 87 years. Distal, proximal, and total gastrectomy (DG, PG, and TG) were performed in 54, 1, and 9 patients, respectively. There were 27, 16, 17, and 4 patients with pStage I, II, III, and IV, respectively. Thirty-day morbidity with Clavien-Dindo grade ≥ 3 and 30-day mortality were 12.5% and 3.1%, respectively. Kaplan–Meier curves for the 3-year OS and RFS demonstrated that survival curves worsened with increasing pStage (p = 0.005 and p < 0.001, respectively). In multivariate analyses for the 3-year OS and RFS, TG and pStage ≥ III were independent risk factors (p = 0.028 and 0.011 in OS, p = 0.021 and 0.001 in RFS). In comparisons of 3-year OSs among the three groups in each cStage, survivals in the surgery group were consistently better than those in the non-surgery and non-ESD group in cStages I to III (p < 0.001, 0.001, and < 0.001 in cStage I, II, and III, respectively).

Conclusion

Our findings suggest that the radical gastrectomy for gastric cancer can be performed safely and has a chance to improve survival even in the oldest-old patients aged ≥ 85 years.