Surgical outcomes and survival after gastrectomy in octogenarians with gastric cancer

Background: The aim of this study was to evaluate the surgical outcomes and survival after gastrectomy in octogenarians and identify the optimal treatment for these patients. Methods: The medical records of 1262 patients with gastric cancer who underwent gastrectomy from January 2003 to December 2012 were reviewed retrospectively. Patients were divided into two age groups: octogenarians (>= 80 y, n = 75) and nonoctogenarians (<80 y, n = 1187). The patients' clinicopathologic data, surgical outcomes, and survival were evaluated. Results: Octogenarians exhibited a higher proportion of female patients, poorer performance scale scores, higher comorbidities, and more advanced tumorenodeemetastasis (TNM) stages than did nonoctogenarians. There was no difference in the surgical curability between the two groups, although octogenarians were more likely to have higher postoperative morbidity and mortality than those of nonoctogenarians. In an analysis of risk factors affecting survival after gastrectomy for octogenarians, only advanced TNM stage was an independent prognostic factor. Overall survival was significantly lower in octogenarians than in nonoctogenarians, whereas disease-specific survival was comparable between the two groups. There was no difference in the disease-specific survival for each stage of cancer after adjustment for tumor stage. Conclusions: Octogenarians had higher postoperative morbidity and mortality rates but comparable cancer-specific survival compared with nonoctogenarians. Only an advanced TNM stage influenced the prognosis of octogenarians. Early detection and thorough postoperative care would improve the overall survival for octogenarians with gastric cancer. (C) 2015 Elsevier Inc. All rights reserved.