Promissing Operation for Gastric Cancer Patients 75 Years of Age and Older -Preoperative Determination Using Pentagon Evaluation System-

Masahiko Nishiyama, Hideaki Irie*, Eiji Miyahara*, Ri Gang*, Tetsuya Toge*

Department of Biochemistry and Biophysics, Department of Surgical Oncology*, Research Institute for Radiation Biology and Medicine, Hiroshima University

We have attempted to show the utility of the pentagon evaluation system, which may provide reliable information about the most appropriate operation for gastric cancer patients 75 years of age and older. The pentagon has 5 different grading axes to evaluate physical status, prognosis, complications, and the quality of life of patients, and consists of pre- and post-operative evaluations. The preoperative pentagon is composed of 5 scores such as ASA physical status classification, deterioration of mental status, daily living activity, cancer staging, and operative procedure. The postoperative pentagon is planned out with a 5 score point system for prognosis (ratio to that of other gastric cancer patients and average life expectancy), postoperative complications, deterioration of mental status, and daily living activity. Risks and the significance of surgery can be estimated by pre- and post-operative application of the pentagon, respectively. Retrospective investigation in 146 patients revealed that the area of the preoperative pentagon related closely to outcomes, though no single score did so. The individual limits of extended operations could be predicted by the score on the operative axis of the preoperative evaluation, which was determined to occupy a 17 cm² area of the pentagon. The pentagon evaluation may be a useful system for selecting the most appropriate operations for gastric cancer patients 75 years of age and older.

Key words
promissing operation for gastric cancer patients, gastric cancer patients 75 years of age and older, pentagon evaluation system of surgical outcomes

Reprint requests
Masahiko Nishiyama Department of Biochemistry and Biophysics, Research Institute for Radiation Biology and Medicine, Hiroshima University
1-2-3 Kasumi, Minami-ku, Hiroshima, 734 JAPAN

Accepted
June 12, 1996

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