Extremely High Mortality Rate after a Successful Gastrectomy for Cancer in Older Adults

Maciej Ciesielski; Wiesław Janusz Kruszewski; Mariusz Szajewski; Jakub Walczak; Natalia Spychalska; Jarosław Szefel; Jacek Zieliński

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자료유형: 학술저널

저자정보: Maciej Ciesielski Wiesław Janusz Kruszewski Mariusz Szajewski Jakub Walczak Natalia Spychalska Jarosław Szefel Jacek Zieliński

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제19권 제2호

발행연도: 2019.1

수록면: 202 - 211 (10page)

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Purpose: Poor physiological reserve for withstanding major cancer surgery in older adults is an important concern in the selection of patients for oncologic gastrectomy. The present study aimed to analyze mortality patterns among patients who underwent gastrectomy for cancer according to age groups. The primary outcomes of this study were early- and middleterm results: 30-day and 3-, 6-, 12-, and 36-month mortality rates. Materials and Methods: A retrospective review of 288 patients who underwent surgical resection for gastric cancer in two centers was carried out. Patients were stratified into four groups according to age: 29–50 years (group I, n=27), 51–65 years (group II, n=117), 66–75 years (group III, n=81), and 76–92 years (group IV, n=58). Statistical calculations focused on the differences in the survival rates between groups I and II as well as between groups II and IV. Results: The middle-aged patients (group II) had significantly better 3-year survival than either the youngest (group I) or the oldest patients (group IV). The 6-month mortality rates were 16.9% in group III and 29.3% in group IV. Two-thirds of the patients from groups III and IV who died between 2 and 6 months after surgery had an uneventful postoperative course. Conclusions: Age is an important prognostic factor of middle-term survival after gastrectomy for cancer. Geriatric assessment and better patient selection for major surgery for cancer are required to improve the outcome of gastrectomy for cancer in patients aged over 75 years.

참고문헌 (25)

참고문헌 신청

Ferlay J / 2015 / Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~E386

Tran TB / 2015 / Outcomes of gastric cancer resection in octogenarians: a multi-institutional study of the U.S. gastric cancer collaborative / Ann Surg Oncol 22:4371~4379

Lu J / 2017 / The preoperative frailty versus inflammation-based prognostic score: which is better as an objective predictor for gastric cancer patients 80 years and older? / Ann Surg Oncol 24:754~762

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