Outcomes of octogenarians undergoing gastrectomy performed for malignancy

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• 作者：Annabelle Teng ; MD^a ; ^{anteng@chpnet.org} ; Geoffrey Bellini ; MD^a ; Erica Pettke ; MD^a ; Michael Passeri ; MD^a ; David Y. Lee ; MD^c ; Keith Rose ; MD^b ; Anton J. Bilchik ; MD^c ; Fadi Attiyeh ; MD ; FACS^a
• 关键词：Gastric cancer ; Gastrectomy ; Elderly ; Octogenarian ; American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP)
• 刊名：Journal of Surgical Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：207
• 期：Complete
• 页码：1-6
• 全文大小：240 K
• 卷排序：207

文摘

Studies on perioperative outcomes of octogenarians with gastric cancer are limited by small sample size. Our aim was to determine the outcomes of gastrectomy and the variation of treatments associated with advanced age (≥80 y).MethodsThe National Surgical Quality Improvement Program database was queried from 2005 to 2011. Patients who underwent gastrectomy for malignancy were identified using International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes.ResultsOf 2591 cases, 487 patients were octogenarians (≥80) and 2104 were nonoctogenarians (<80). Overall, 4.9% of patients had disseminated cancer. Octogenarians had higher 30-d mortality (7.2% versus 2.5%, P < 0.01) and more major complications (31.4% versus 25.5%, P < 0.01), though fewer octogenarians underwent total gastrectomy (24.0% versus 43.2%, P < 0.01) and extended lymphadenectomy (10.1% versus 17.4%, P < 0.01) than the nonoctogenarian cohort. On multivariate analysis, age ≥80 y was associated with major complications (OR, 1.3; 95% CI, 1.03-1.6; P = 0.03) and increased mortality (OR, 3.0; 95% CI, 1.9-4.9; P < 0.01).ConclusionsAdvanced age (≥80 y) was associated with worse outcomes in patients undergoing gastrectomy for malignancy. Therefore, careful staging is necessary to reduce unnecessary operations in this population. Furthermore, surgeons must place greater attention on optimizing the octogenarian population before surgery.