Clinicopathological Characteristics and Surgical Outcome of Gastric Carcinoma with Regard to Aging

Tsuneaki Fujiya, Koujin Endoh, Jyunichi Mikuni, Yoichiro Kakugawa, Yasuhiko Kamiyama, Hidemaro Ono, Tohru Sugawara, Kiyoaki Ouchi

Department of Surgery, Miyagi Cancer Center

From 1967 to 1990 a total of 2350 patients underwent gastrectomies for gastric cancer. These patients were divided into 3 groups (49 years or less: the younger group n=511, 50-69: the middle aged group n=1476, 70 years or higher: the elder group n=363), and the elder group was compared with other groups in the terms of clinicopathological features and surgical outcome. The incidence of tumor localized upper third or lower third in the stomach or protruded from the surrounding mucosa was significantly higher in the elder group than in the others. There was no significant difference among those groups with regard to depth of invasion, extent of lymph node metastasis, peritoneal dissemination and liver metastasis. The differentiated type of tumor was more frequently seen in the elder group than in the others. The rates of double or multicentric cancer were higher in the elder group than in the others. Alghough 5-year survival rate of the elder group following curative resection was significantly lower than that of the middle-aged and younger groups, there was no difference of relative survival rates among 3 groups. Hazard ratio of the middle-aged and younger groups comparing with the elder group was 0.61 and 0.51 respectively. These results indicate that surgical outcome of the eldery was not different from that of others, operation should be aimed at relatively curative intent and the most important factor affecting the long-term survival in the elderly was the death caused by other diseases.

Key words
gastric cancer, surgical treatment of gastric cancer, gastric cancer in elderly, prognostic factor of gastric cancer, multivariate analysis of gastric cancer

Reprint requests
Tsuneaki Fujiya Department of Surgery, Miyagi Cancer Center
47-1 Nodayama, Medeshima-Shiode, Natori, 981-12 JAPAN

Accepted
February 12, 1997

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