Daisuke Takeuchi1, Naohiko Koide2, Akira Suzuki3, Satoshi Ishizone3, Fumiaki Shimizu4, Takuji Tsuchiya4, Shigeyoshi Kumeda2, Shinichi Miyagawa3. 1. Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. Electronic address: takeuchi_daichan@yahoo.co.jp. 2. Department of Surgery, Nagano Prefectural Kiso Hospital, Fukushima, Japan. 3. Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan. 4. Department of Surgery, Shinshu Ueda Medical Center, Ueda, Japan.
Abstract
BACKGROUND: Elderly patients undergoing gastrectomy are expected to be at high risk of postoperative complications. This retrospective multicenter cohort study assessed complications and long-term outcomes after gastrectomy for gastric cancer (GC). METHODS: A total of 993 patients with GC who had undergone gastrectomy were included, comprising 186 elderly patients (age ≥ 80 y, E group) and 807 nonelderly patients (age ≤ 79 y, NE group). Preoperative comorbidities, operative results, postoperative complications, and clinical outcomes were compared between the groups. RESULTS: Clavien-Dindo grade ≥1 postoperative complications, pneumonia (P = 0.02), delirium (P < 0.001), and urinary tract infection (P < 0.001) were more common in the E group. Postoperative pneumonia was associated with mortality in this group (P < 0.001). Three patients (1.6%) died after surgery, each of whom had pneumonia. Severe postoperative complication was independently prognostic of overall (hazard ratio, 4.69; 95% confidence interval, 2.40-9.14; P < 0.001) and disease-specific (hazard ratio, 6.41; 95% confidence interval 2.92-14.1; P < 0.001) survival in the E group. CONCLUSIONS: In elderly patients with GC, clinical outcomes are strongly associated with severe postoperative complications. Preventing such complications may improve survival.
BACKGROUND: Elderly patients undergoing gastrectomy are expected to be at high risk of postoperative complications. This retrospective multicenter cohort study assessed complications and long-term outcomes after gastrectomy for gastric cancer (GC). METHODS: A total of 993 patients with GC who had undergone gastrectomy were included, comprising 186 elderly patients (age ≥ 80 y, E group) and 807 nonelderly patients (age ≤ 79 y, NE group). Preoperative comorbidities, operative results, postoperative complications, and clinical outcomes were compared between the groups. RESULTS: Clavien-Dindo grade ≥1 postoperative complications, pneumonia (P = 0.02), delirium (P < 0.001), and urinary tract infection (P < 0.001) were more common in the E group. Postoperative pneumonia was associated with mortality in this group (P < 0.001). Three patients (1.6%) died after surgery, each of whom had pneumonia. Severe postoperative complication was independently prognostic of overall (hazard ratio, 4.69; 95% confidence interval, 2.40-9.14; P < 0.001) and disease-specific (hazard ratio, 6.41; 95% confidence interval 2.92-14.1; P < 0.001) survival in the E group. CONCLUSIONS: In elderly patients with GC, clinical outcomes are strongly associated with severe postoperative complications. Preventing such complications may improve survival.
Authors: Trevor D Hamilton; Alyson L Mahar; Barbara Haas; Kaitlyn Beyfuss; Calvin H L Law; Paul J Karanicolas; Natalie G Coburn; Julie Hallet Journal: Gastric Cancer Date: 2017-12-11 Impact factor: 7.370
Authors: Francesco Casella; Andrea Sansonetti; Andrea Zanoni; Cofini Vincenza; Alberto Capodacqua; Roberto Verzaro Journal: Updates Surg Date: 2017-05-10
Authors: Meghan Karuturi; Melisa L Wong; Tina Hsu; Gretchen G Kimmick; Stuart M Lichtman; Holly M Holmes; Sharon K Inouye; William Dale; Kah P Loh; Mary I Whitehead; Allison Magnuson; Arti Hurria; Michelle C Janelsins; Supriya Mohile Journal: J Geriatr Oncol Date: 2016-06-07 Impact factor: 3.599