Surgical outcomes and prognostic factors of gastric cancer surgery in octogenarians

Abstract

Gastric cancer is the fifth most common cancer worldwide and the third leading cause of cancer-related deaths. It also has the highest incidence in East Asian, Central Asian, and Latin American populations. Among these, Korean men have the highest incidence [1]. As lifespans continue to increase, 10% to 20% of patients with gastric cancer are now over 80 years of age in developed countries [2]. In Japan, in 2009, 22.7% of the population were over 65 years old and 6.2% were over 80 years old, compared with only 5.7% and 0.7% in 1960, respectively [3]. In the United States, octogenarians (age ≥ 80 years) constitute 14% of the population aged 60 years or older, but by 2050, it is anticipated that 20% of the older population will be 80 years old or older. As the elderly population continues to increase, it is concerning that more than 50% of gastric cancers are observed in the elderly [4]. In Europe in 1990, the peak of gastric cancer incidence was observed among populations aged 85 or more [5]. Patients in this age group have declining organ capacity and might have comorbidities such as cardiovascular disease and pulmonary dysfunction, so deciding to perform a gastrectomy in elderly patients must be done carefully by assessing the patients’ tolerance of surgical stress. Radical gastrectomy in elderly patients has an increased risk of morbidity and mortality, but there is some evidence that elderly Original Article Korean Journal of Clinical Oncology 2019;15:112-120 https://doi.org/10.14216/kjco.19020 pISSN 1738-8082 ∙ eISSN 2288-4084