Study of Gastrectomy for Gastric Cancer in Patients Aged 80 Years and Older

Akihiko Watanabe, Takashi Yamada, Hidetomo Sawada, Yukishige Yamada, Tomoaki Yano, Naoto Ueyama, Masahiro Tanase, Hiroshige Nakano

First Department of Surgery, Nara Medical University

Between 1982 and 1991, a total of 710 patients underwent gastrectomy for gastric cancer in the First Department of Surgery, Nara Medical University. Of these, 78 elderly patients aged 75 and older were divided into two age groups: 54 patients aged between 75 and 79 (defined Group A) and 24 patients aged 80 and older (defined Group B). Preoperative organ dysfunctions, operation method, postoperative complications and prognosis were compared in these two groups. As preoperative organ dysfunctions, cardiac dysfunction and diabetes mellitus were more frequently seen in Group B than in Group A. In Group B, the extent of gastrectomy and lymphnode dissection were minimized in so far as possible to obtain a shorter operation time and less intraoperative blood loss. The incidence of postoperative morbidity was 50.0% in Group A and 70.8% in Group B. As complications, cardiac insufficiency, pulmonary disease and delirium were more frequently seen in Group B than in Group A. The main cause of death was due to cancer recurrence in Group A, while it was other diseases and postoperative complications in Group B. These results suggest that, in elderly gastric cancer patients, aggressive surgery for curative resection is recommended in patients under 80, but an adequate procedure with special care should be selected to prevent postoperative complications in patients aged 80 and older.

Key words
gastric cancer in patients aged 80 years and older

Reprint requests
Akihiko Watanabe First Department of Surgery, Nara Medical University
840 Shijo-cho, Kashihara City, 634 JAPAN

Accepted
May 11, 1993

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