Survival outcomes of geriatric patients with clinically resectable gastric cancer: to operate or not

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• 作者：Keng-Hao Liu ; MD^a ; ¹ ; Chia-Yen Hung ; MD^b ; ¹ ; Chang-Hsien Lu ; MD^c ; Jun-Te Hsu ; MD^a ; Ta-Sen Yeh ; MD^a ; Yung-Chang Lin ; MD^b ; Yu-Shin Hung ; MD^b ; Wen-Chi Chou ; MD^b ; ^d ; ^{wenchi3992@yahoo.com.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Gastric cancer ; Surgical resection ; Geriatric patient ; Prognosis
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：206
• 期：2
• 页码：481-489
• 全文大小：771 K

文摘

Approximately, 50% of all gastric cancer patients are aged >70 y. Although curative surgery is the treatment of choice, many geriatric patients die of surgical complications. Therefore, we aimed to evaluate the impact of radical surgery on the survival outcome of geriatric patients with resectable gastric cancers.

Methods

About 488 patients diagnosed with resectable gastric cancers, aged ≥70 y, between January 2007 and December 2012 at Chang Gung Memorial Hospital (CGMH) Linkou branch were included in this study. Using univariate and multivariate analyses, possible prognostic variables for survival outcome were assessed in 445 patients (91.2%) treated with radical surgery (operation [OP] group) and 43 (8.8%) receiving conservative treatment (non-OP group). The impact of radical surgery on survival outcomes was evaluated according to CGMH scores.

Results

On multivariate analysis, surgical resection with subtotal gastrectomy and CGMH score were the only independent prognostic factors for both overall and cancer-specific survival. The median survival time was 43 mo for the entire cohort. The OP group had significantly better survival outcome than the non-OP group (median survival, 50.3 versus 16.2 mo, P < 0.001). The median survival times for patients with CGMH scores ≤20 were 64.1 and 20.0 mo (P < 0.002) and those for patients with CGMH scores >20 were 13.8 and 10.4 mo (P = 0.18) in the OP and non-OP groups, respectively.

Conclusions

Surgical resection and CGMH score are independent prognostic factors for overall and cancer-specific survival; the CGMH score might be a prognostic indicator of surgical outcome in geriatric patients with resectable gastric cancers.