Abstract
We analyzed the records of 44 gastric cancer patients aged 80 years or older who had undergone gastrectomy (7 total, 3 proximal and 34 distal) between 1972 and 1990. Of these, 18 patients (40.9%) had stage 1 cancer, 11 patients (25.0%) has stage 4 cancer and 19 patients (43.8%) had preoperative organ impairment. The operative morbidity was 43.8% (19 patients) and the mortality rate was 4.5% (2 patients). However, there was no relation between preoperative organ impairment and postoperative complications. The cumulative 5-year survival rate was 46.1% overall. The 5-year survival rate for the patients without serosal invasion was 60.6%, as compared to 23.9% with serosal invasion (p<0.01). The degree of serosal invasion, lymph node involvement and tumor size were all found to be significantly associated with long-term survival, whereas sex, type of operation, and tumor grade were not. Twenty patients died in the long term. The main cause of death of patients with serosal invasion was cancer recurrence, while for those without serosal invasion death was due to other causes. It is concluded that gastrectomy for gastric cancer patients aged 80 or older can be performed safely and R1 lymph node resection gastrectomy should be recommended for patients without serosal invasion. More radical gastrectomy should be recommended for patients with serosal invasion.
