Current Status of Gastrectomy for Gastric Cancer in Oldest-old Patients Aged 85 Years or Older.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-03-22 DOI:10.1007/s12029-025-01205-z

Kazuaki Matsui, Yoshiki Kawaguchi, Takahiro Iwai, Yukiko Torizaki, Yoko Adachi, Hirofumi Shimoda, Takehiro Shimada, Yasuhito Sekimoto, Hidejiro Urakami, Shiko Seki

{"title":"Current Status of Gastrectomy for Gastric Cancer in Oldest-old Patients Aged 85 Years or Older.","authors":"Kazuaki Matsui, Yoshiki Kawaguchi, Takahiro Iwai, Yukiko Torizaki, Yoko Adachi, Hirofumi Shimoda, Takehiro Shimada, Yasuhito Sekimoto, Hidejiro Urakami, Shiko Seki","doi":"10.1007/s12029-025-01205-z","DOIUrl":null,"url":null,"abstract":"Purpose: This study aimed to investigate the safety of gastrectomy for gastric cancer in oldest-old patients aged ≥ 85 years.Methods: This study retrospectively analyzed the patients aged ≥ 85 years who diagnosed with gastric cancer between 2008 and 2022. The study patients were divided into three groups: a surgery group, an endoscopic submucosal dissection (ESD) group, and a non-surgery and non-ESD group (n = 64, 57, and 152). Surgical outcomes and 3-year overall and recurrence-free survival (OS and RFS) were investigated.Results: In the surgery group, the study cohort comprised 30 males and 34 females with a median age of 87 years. Distal, proximal, and total gastrectomy (DG, PG, and TG) were performed in 54, 1, and 9 patients, respectively. There were 27, 16, 17, and 4 patients with pStage I, II, III, and IV, respectively. Thirty-day morbidity with Clavien-Dindo grade ≥ 3 and 30-day mortality were 12.5% and 3.1%, respectively. Kaplan-Meier curves for the 3-year OS and RFS demonstrated that survival curves worsened with increasing pStage (p = 0.005 and p < 0.001, respectively). In multivariate analyses for the 3-year OS and RFS, TG and pStage ≥ III were independent risk factors (p = 0.028 and 0.011 in OS, p = 0.021 and 0.001 in RFS). In comparisons of 3-year OSs among the three groups in each cStage, survivals in the surgery group were consistently better than those in the non-surgery and non-ESD group in cStages I to III (p < 0.001, 0.001, and < 0.001 in cStage I, II, and III, respectively).Conclusion: Our findings suggest that the radical gastrectomy for gastric cancer can be performed safely and has a chance to improve survival even in the oldest-old patients aged ≥ 85 years.","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"83"},"PeriodicalIF":1.6000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01205-z","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: This study aimed to investigate the safety of gastrectomy for gastric cancer in oldest-old patients aged ≥ 85 years.

Methods: This study retrospectively analyzed the patients aged ≥ 85 years who diagnosed with gastric cancer between 2008 and 2022. The study patients were divided into three groups: a surgery group, an endoscopic submucosal dissection (ESD) group, and a non-surgery and non-ESD group (n = 64, 57, and 152). Surgical outcomes and 3-year overall and recurrence-free survival (OS and RFS) were investigated.

Results: In the surgery group, the study cohort comprised 30 males and 34 females with a median age of 87 years. Distal, proximal, and total gastrectomy (DG, PG, and TG) were performed in 54, 1, and 9 patients, respectively. There were 27, 16, 17, and 4 patients with pStage I, II, III, and IV, respectively. Thirty-day morbidity with Clavien-Dindo grade ≥ 3 and 30-day mortality were 12.5% and 3.1%, respectively. Kaplan-Meier curves for the 3-year OS and RFS demonstrated that survival curves worsened with increasing pStage (p = 0.005 and p < 0.001, respectively). In multivariate analyses for the 3-year OS and RFS, TG and pStage ≥ III were independent risk factors (p = 0.028 and 0.011 in OS, p = 0.021 and 0.001 in RFS). In comparisons of 3-year OSs among the three groups in each cStage, survivals in the surgery group were consistently better than those in the non-surgery and non-ESD group in cStages I to III (p < 0.001, 0.001, and < 0.001 in cStage I, II, and III, respectively).

Conclusion: Our findings suggest that the radical gastrectomy for gastric cancer can be performed safely and has a chance to improve survival even in the oldest-old patients aged ≥ 85 years.

查看原文本刊更多论文

85岁及以上高龄胃癌患者胃切除术的现状。

目的：本研究旨在探讨≥85岁高龄高龄胃癌患者行胃切除术的安全性。方法：回顾性分析2008 - 2022年间年龄≥85岁的胃癌患者。研究患者分为三组：手术组、内镜下粘膜剥离（ESD）组、非手术和非ESD组（n = 64、57和152）。研究了手术结果和3年总生存率和无复发生存率（OS和RFS）。结果：在手术组中，研究队列包括30名男性和34名女性，中位年龄为87岁。分别对54例、1例和9例患者进行了远端、近端和全胃切除术（DG、PG和TG）。pi、II、III和IV期患者分别为27例、16例、17例和4例。Clavien-Dindo分级≥3的30天发病率和30天死亡率分别为12.5%和3.1%。3年OS和RFS的Kaplan-Meier曲线显示，生存曲线随着pStage的增加而恶化（p = 0.005和p）。结论：我们的研究结果表明，胃癌根治术可以安全进行，即使是年龄≥85岁的高龄患者也有机会提高生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.