Analysis of Clinicopathological Features and Risk Factors for Severe Complications after Gastrectomy for Gastric Cancer in Elderly Patients

Objective: As life expectancy is increasing, the number and proportion of elderly patients with gastric cancer are also expanded. This study aimed to investigate the clinicopathological features for elderly gastric cancer patients undergoing gastrectomy and analyze risk factors for developing severe complications.Methods: A total of 514 patients treated surgically for gastric cancer between January 2016 and December 2019 were enrolled in this retrospective study. Patients were divided into two groups: younger group ( ≤ 69 years) and elderly group ( ≥ 70 years). Clinicopathological characteristics and operative outcomes including the complications and mortality were compared between two groups. Risk factors for severe complications in elderly gastric cancer patients were also investigated.Results: Of the 514 patients, 145 (28.2%) were elderly group. Comorbidity (P < 0.001), differentiated histology (P = -0.006), deeper in tumor depth (P = 0.012), and frequent lymph node metastasis (P = 0.028) were observed in elderly group. Overall complications (P = 0.046) and severe complications (P = 0.049) were significantly higher in elderly group. Multivariate analysis indicated that extent of resection (P = 0.044) was associated with severe complications in elderly gastric cancer patients.Conclusion: Elderly patients have a significantly higher probability of complications and severe complications than younger patients after gastrectomy for gastric cancer. Especially, when total gastrectomy was performed in elderly gastric cancer patients, the risk of developing serious complications was significantly higher more than 3 times. Therefore, surgeons should pay attention to gastric cancer patients over the age of 70 who require total gastrectomy.