Survival after surgery for gastric cancer in patients over 70 years of age

Background and Aims: The increase of the elderly population in western soci eties will result in a considerable increase of gastric cancer patients old er than 70 years requiring surgery. However, higher postoperative morbidity and mortality rates after major surgery in the elderly are well recognized . The aim of this study was to evaluate the risk factors of mortality and p redictors of survival in elderly patients with gastric cancer. Methodology: We reviewed the data of the 165 patients evaluated for gastric cancer surgery in the Oulu University Hospital from January 1985 fill Dece mber 1994 and made a computer analysis. Results: Postoperative mortality was 12% both after all laparotomies and af ter all resections, and 6% after radical resections. Mortality after radica l resection did not associate significantly with any clinical variable but morbidity was associated with the number of coexistent diseases. The median and cumulative 5-year survivals after radical resections were 40 months an d 38%. Survival was closely related to diagnostic delay, preoperative loss of weight, two or more coexistent disease, location of tumor, and recurrenc e in univariate analysis, but multivariate analysis showed only preoperativ e weight loss and recurrent disease to be independent predictors of surviva l. Conclusions: Age alone is not a risk factor for postoperative mortality or a predictor of survival among elderly patients with gastric cancer. Early d etection of malignancy and careful preoperative evaluation of the patients referred for resection are needed to improve survival.