Gastric resection in the aged (>= 80 years) with gastric carcinoma: A multivariate analysis of prognostic factors

Background: The incidence of gastric neoplasm is increasing in the elderly population. Therefore, a rational method of treatment for gastric cancer in the elderly should be constituted to improve the survival. The purpose of the present study was to clarify whether the patient's age is an independen t prognostic factor and to determine clinicopathological characteristics in the elderly. Methods: Curative resection of gastric cancer was carried out on 601 patien ts who were 40 years or older. They were divided into the following two gro ups: younger patients (between 40 and 79 years old) and elderly patients (8 0 years or older). The clinicopathologic features of these patients were re viewed retrospectively and multivariate analysis was carried out. Results: The distinguishing features of gastric cancer in the elderly patie nts were intestinal and mixed types of cancer, distal third stomach dominan cy in the tumour location, advanced stage of disease, and a low rate of ext ensive lymph node dissection (D3 or more). Regarding the recurrence site, t he liver was the dominant site in the elderly group (25.3% in the younger g roup vs 54.5% in the elderly group). The 10-year disease-free survival rate of the elderly group was 53.2%, which was significantly worse than that (7 9.9%) of the younger patients (P = 0.0004). In multivariate analysis, an ag e of greater than or equal to 80 years is an independent prognostic factor, as well as stage, depth of tumour invasion, lymph node metastasis, scirrho us carcinoma, and blood transfusion. Conclusions: Results indicate that gastric cancer in elderly patients has a poorer prognosis than that in younger patients.