Operative Risk Factors in Gastric Cancer Surgery for Elderly Patients

Abstract

Purpose: Gastric cancer surgery is popular operation in East Asia like Korea and Japan. Recently, population of elderly has been significantly increased. As results, surgery for gastric cancer surgery for elderly will be also increased. We evaluated the effect of old age on gastric cancer surgery, and analyzed the operative risk factors for elderly patients.

Method & methods: From November 2008 to August 2010, 590 patients who were underwent curative resection for gastric cancers were enrolled. Patients who underwent palliative surgery or emergency operations were excluded, and we analyzed the correlation between surgical outcomes and age retrospectively. We defined that elderly was patients with over 65 year old.

Results: Mean age of all patients was 58.3 year old, and complications were occurred in 87 cases (14.7%). Most common complication was wound infection and severe complication which required surgical, endoscopic or radiologic intervention were developed in 52 cases (8.8%).

As patients’ age increase, complication rate also have been increased. In univariate analysis, age, comorbidity, extend of resection, operation time and combined resection were correlated with surgical complication. Especially, age with over 75 year old, operation time and comorbidity were predictive factors in multivariate analysis. In the elderly, comorbidity and extend of resection was related with surgical complication.

Conclusions: Patients’ age was most important factor for predicting surgical complications. Surgeon should pay an attention to perform gastric cancer surgery for elderly. In particularly, total gastrectomy has to be performed carefully for elderly who have comorbidity.