Prognostic factors for gastrectomy in elderly patients with gastric cancer
Prognostic factors for gastrectomy in elderly patients with gastric cancer
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DOI：
10.1186/s12957-017-1131-6
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发表时间：
2017-03-11
影响因子：
3.2
通讯作者：
Hirai, Toshihiro
中科院分区：
文献类型：
--
作者：
Ueno, Daisuke;Matsumoto, Hideo;Hirai, Toshihiro
背景资料：方法：回顾性分析2007年1月至2014年12月我院收治的366例胃癌手术患者的临床资料，分析年龄因素对胃癌手术预后的影响。在366例患者中，117例年龄≥ 75岁，249例年龄≥ 74岁。所有被确定为显着使用单变量分析的因素包括在多变量analysis.Results：中位随访时间为52.9个月（范围，1.0-117.5个月）。我们发现，在75岁或以上的患者中，术后并发症和癌症程度是总生存率和无病生存率的独立预后因素。相反，在74岁或更年轻的患者中，只有淋巴结状态和术后化疗分别是总生存率和无病生存率的独立预后因素。病理结果和术后并发症是75岁或以上胃癌患者生存的重要预后因素，而病理结果和术后化疗是74岁或以下患者生存的重要预后因素。由于术后并发症的预防可能有助于改善老年胃癌患者的预后，我们建议有必要考虑有限的手术，而不是根治性手术，这取决于患者的一般情况和合并症。
Background: The aim of the present study was to investigate the age-specific prognostic factors in patients who underwent gastrectomy for gastric cancer.Methods: The medical records of 366 patients with gastric cancer who underwent surgical resection at our hospital between January 2007 and December 2014 were retrospectively reviewed. Of the 366 patients, 117 were aged 75 years or older and 249 were aged 74 years or younger. All factors that were identified as significant using univariate analysis were included in the multivariate analysis.Results: The median follow-up duration was 52.9 months (range, 1.0-117.5 months). We found that in patients aged 75 years or older, postoperative complications and the extent of cancer were independent prognostic factors of overall survival and disease-free survival. In contrast, in patients aged 74 years or younger, only the lymph node status and postoperative chemotherapy were independent prognostic factors for overall survival and disease-free survival, respectively.Conclusions: Pathological outcomes and postoperative complications are important prognostic factors for survival in patients aged 75 years or older with gastric cancer, whereas pathological outcomes and postoperative chemotherapy are important prognostic factors for survival in patients aged 74 years or younger. Because the prevention of postoperative complications may contribute to improvements in the prognosis of elderly patients with gastric cancer, we suggest that it is necessary to consider limited surgery instead of radical surgery, depending on the patient's general condition and co-morbidities.