Evaluation of treatment strategies for gastric cancer in the elderly according to the number of abnormal parameters on preoperative examination

The treatment strategies in patients with gastric cancer aged 80 years or o lder have not yet been well defined. We examined the incidence of postopera tive complications and hospital mortality regarding the preoperative condit ion of such patients. A preoperative examination included evaluations of th e cardiac, pulmonary, renal, and hepatic functions, the presence or absence of anemia, nutritional status, and blood sugar content. The incidence of p ostoperative complications and hospital mortality were then studied in rela tion to the number of preoperative abnormal parameters. The incidence of po stoperative complications was 37.0%, The rate of hospital mortality was 11. 1%. Among the patients with abnormalities in five or more items, the incide nce of complications was 76.9% and the rate of hospital mortality was 23.1% . In the patients,vith an operative time of 4 h or longer, the same inciden ce was 71.4%, Among the patients who underwent a curative resection, the 5- year survival rate was 92.3%, For elderly gastric cancer patients with abno rmalities in five or more items during a preoperative examination and for t hose showing a poor level of daily life activity, a less invasive treatment modality should be planned, Patients with abnormalities of four or fewer i tems at a preoperative examination appear to be good candidates for curativ e resection.