2024 Volume 58 Issue 5 Pages 171-175
Background: Pneumonia is a major cause of death in the elderly population. Early gastric cancer is mostly curable through surgery alone; however, considering the body weight loss, muscle loss, and reflux after gastrectomy, elderly patients are at very high risk for pneumonia, which could decrease overall survival. We aimed to clarify the incidence of long－term postoperative pneumonia (LTPP) in the elderly and its association with postoperative muscle loss.
Methods: We retrospectively examined patients over 75 years of age who underwent R0 gastrectomy for gastric cancer and were diagnosed with T1 disease at the National Cancer Center Hospital between 2005 and 2012. LTPP was diagnosed by chest computed tomography performed up to 1 year after surgery, and patients were divided into two groups depending on the appearance of new pneumonia on CT. The presence of preoperative sarcopenia was assessed using the preoperative L3 skeletal muscle index.
Results: A total of 156 patients were included in this study. LTPP was observed in 32 (20.5%) patients. Background factors were not significantly different between patients with and without new pneumonia. The median muscle loss rate was 17.4% in those with LTPP and 12.4% in those without LTPP. Those with LTPP had lost significantly more muscle than those without LTPP (p = 0.008).
Conclusions: LTPP was frequently observed in the elderly patients, suggesting that the incidence of pneumonia was associated with muscle loss.
