Details

Autor(en) / Beteiligte

• Brown, L R
• Kamarajah, S K
• Madhavan, A
• Wahed, S
• Navidi, M
• Immanuel, A
• Hayes, N
• Phillips, A W

Titel

The impact of age on long-term survival following gastrectomy for gastric cancer

Ist Teil von

• Annals of the Royal College of Surgeons of England, 2023-03, Vol.105 (3), p.269-277

Ort / Verlag

England

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Gastrectomy remains the primary curative treatment modality for patients with gastric cancer. Concerns exist about offering surgery with a high associated morbidity and mortality to elderly patients. The study aimed to evaluate the long-term survival of patients with gastric cancer who underwent gastrectomy comparing patients aged <70 years with patients aged ≥70 years. Consecutive patients who underwent gastrectomy for adenocarcinoma with curative intent between January 2000 and December 2017 at a single centre were included. Patients were stratified by age with a cut-off of 70 years used to create two cohorts. Log rank test was used to compare overall survival and Cox multivariable regression used to identify predictors of long-term survival. During the study period, 959 patients underwent gastrectomy, 520 of whom (54%) were aged ≥70 years. Those aged <70 years had significantly lower American Society of Anesthesiologists grades ( <0.001) and were more likely to receive neoadjuvant chemotherapy (39% vs 21%; <0.001). Overall complication rate ( =0.001) and 30-day postoperative mortality ( =0.007) were lower in those aged <70 years. Long-term survival (median 54 vs 73 months; <0.001) was also favourable in the younger cohort. Following adjustment for confounding variables, age ≥70 years remained a predictor of poorer long-term survival following gastrectomy (hazard ratio 1.35, 95% confidence interval 1.09, 1.67; =0.006). Low postoperative mortality and good long-term survival were demonstrated for both age groups following gastrectomy. Age ≥70 years was, however, associated with poorer outcomes. This should be regarded as important factor when counselling patients regarding treatment options.