The perioperative outcomes of gastric cancer surgery in octogenarians

Can Uç; Tolga Girgin; Osman Bozbıyık; Taylan Özgür Sezer; Ozgur Fırat; Muhtar Sinan Ersin

doi:10.19161/etd.1498348

TR EN

Yaşlı hastalarda mide kanseri cerrahisinin perioperatif sonuçlarının değerlendirilmesi

Öz

Amaç: Mide kanseri dünyada en sık görülen beşinci kanserdir. Toplumun yaşlanmasıyla beraber ileri yaş grubunda da mide kanseri görülebilmektedir. Çalışmamızın amacı 80 yaş ve üstü hastalarda mide kanseri cerrahisinin erken dönem sonuçlarının değerlendirilmesidir. Gereç ve Yöntem: Ocak 2015 Haziran 2022 tarihleri arasında mide kanseri nedeniyle opere edilen 80 yaş ve üstü hastalar; klinik, histopatolojik ve erken dönem perioperatif sonuçlar retrospektif olarak değerlendirildi. Bulgular: Çalışmaya toplam 23 hasta dahil edildi. Hastaların yaş ortalaması 81.9 idi. Hastaların sekizi kadın 15’i erkekti. Üç hastaya neoadjuvant sistemik tedavi uygulanmış idi. On bir hastaya total gastrektomi, beş hastaya distal gastrektomi, yedi hastaya proksimal gastrektomi uygulandı. İlk 90 günde iki hastada (%8,69) eksitus, üç hastada (%13,04) morbidite gelişti. Sonuç: Yaşlı hasta grubu özel bir hasta grubudur. Tedavi süreci planlanırken hasta bazlı karar verilmelidir. Mümkünse medikal olarak fit hasta grubuna cerrahi rezeksiyon uygulanmalıdır.

Anahtar Kelimeler

The perioperative outcomes of gastric cancer surgery in octogenarians

Abstract

Aim: Gastric cancer is the fifth most common cancer in the world and the third most common cause of cancer related deaths. Its incidence is also increasing in elderly patients. A patient based, multidisciplinary treatment approach is required in the evaluation of elderly patients. Surgical resection is the curative method in the treatment of gastric cancer. We aimed to evaluate the early surgical outcomes, mortality and morbidity of patients aged 80 years and older who were operated for gastric cancer. Materials and Methods: Patients aged 80 years and older who underwent surgery for gastric adenocarcinoma between January 2015 and June 2022 were retrospectively analyzed. Demographic, clinical, and histopathological parameters and postoperative outcomes were evaluated. Results: Twenty three patients aged 80 years and older were included in the study. The mean age was 81.95 ± 3.11 (Range 80 96) years. 8 were female and 15 were male. 5 patients were ASA I, 11 patients were ASA II, and 7 patients were ASA III. Three patients received neoadjuvant chemotherapy. Total gastrectomy was performed in 11 patients, distal gastrectomy in 5 patients, and proximal gastrectomy in 7 patients. The mean number of lymph nodes removed was 19.87±12.61. The mean hospital stay length was 9.34 ± 3.45 days. The mortality rate in the first ninety days of our study was 8.69% and morbidity was 13,04%. Conclusion: Octogenarians are a special patient group. The treatment plan should be individualized. If possible, all medically fit patients should undergo curative surgery.

Keywords

References

Popovic JR. 1999 National Hospital Discharge Survey: annual summary with detailed diagnosis and procedure data. Vital Health Stat 13. 2001 Sep;(151):i–v, 1–206.
Adam R, Frilling A, Elias D, Laurent C, Ramos E, Capussotti L, et al. Liver resection of colorectal metastases in elderly patients. Br J Surg. 2010 Mar;97(3):366–76.
Gerstenhaber F, Grossman J, Lubezky N, Itzkowitz E, Nachmany I, Sever R, et al. Pancreaticoduodenectomy in elderly adults: is it justified in terms of mortality, long-term morbidity, and quality of life? J Am Geriatr Soc. 2013 Aug;61(8):1351–7.
Melis M, Marcon F, Masi A, Pinna A, Sarpel U, Miller G, et al. The safety of a pancreaticoduodenectomy in patients older than 80 years: risk vs. benefits. HPB. 2012 Sep;14(9):583–8.
Al-Refaie WB, Parsons HM, Henderson WG, Jensen EH, Tuttle TM, Vickers SM, et al. Major cancer surgery in the elderly: results from the American College of Surgeons National Surgical Quality Improvement Program. Ann Surg. 2010 Feb;251(2):311–8.
Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Prz Gastroenterol. 2019;14(1):26–38.
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol. 2012 Aug;13(8):790–801.
Horvath B, Kloesel B, Todd MM, Cole DJ, Prielipp RC. The Evolution, Current Value, and Future of the American Society of Anesthesiologists Physical Status Classification System. Anesthesiology. 2021 Nov 1;135(5):904–19.

Ye J, Ren Y, Wei Z, Hou X, Dai W, Cai S, et al. External validation of a modified 8th AJCC TNM system for advanced gastric cancer: Long-term results in southern China. Surg Oncol. 2018 Jun;27(2):146–53.
Dindo D, Demartines N, Clavien PA. Classification of Surgical Complications. Ann Surg. 2004 Aug;240(2):205–13.
Lin HS, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016 Aug 31;16(1):157.
Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008–2030): a population-based study. Lancet Oncol. 2012 Aug;13(8):790–801.
Pisanu A, Montisci A, Piu S, Uccheddu A. Curative surgery for gastric cancer in the elderly: treatment decisions, surgical morbidity, mortality, prognosis and quality of life. Tumori. 2007;93(5):478–84.
Saif MW, Makrilia N, Zalonis A, Merikas M, Syrigos K. Gastric cancer in the elderly: an overview. Eur J Surg Oncol. 2010 Aug;36(8):709–17.
Fujiwara S, Noguchi T, Harada K, Noguchi T, Wada S, Moriyama H. How should we treat gastric cancer in the very elderly? Hepatogastroenterology. 2012;59(114):620–2.
Coniglio A, Tiberio GAM, Busti M, Gaverini G, Baiocchi L, Piardi T, et al. Surgical treatment for gastric carcinoma in the elderly. J Surg Oncol. 2004 Dec 15;88(4):201–5.
Saif MW, Makrilia N, Zalonis A, Merikas M, Syrigos K. Gastric cancer in the elderly: an overview. Eur J Surg Oncol. 2010 Aug;36(8):709–17.
Fujiwara Y, Fukuda S, Tsujie M, Ishikawa H, Kitani K, Inoue K, et al. Effects of age on survival and morbidity in gastric cancer patients undergoing gastrectomy. World J Gastrointest Oncol. 2017 Jun 15;9(6):257–62.
Konishi H, Ichikawa D, Itoh H, Fukuda K, Kakihara N, Takemura M, et al. Surgery for gastric cancer patients of age 85 and older: Multicenter survey. World J Gastroenterol. 2017 Feb 21;23(7):1215–23.
Schendel J, Jost E, Mah M, Mack L, McCall M, Gu N, et al. Gastric cancer management in elderly patients: a population-based study of treatment patterns and outcomes in gastric cancer patients ≥ 75 years from Alberta, Canada. Am J Surg. 2021 Apr;221(4):839–43.
Fujisaki M, Shinohara T, Hanyu N, Kawano S, Tanaka Y, Watanabe A, et al. Laparoscopic gastrectomy for gastric cancer in the elderly patients. Surg Endosc. 2016 Apr;30(4):1380–7.
Gagnière J, Veziant J, Pereira B, Pezet D, Le Roy B, Slim K. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for the Elderly: Is It Reasonable? A Meta-Analysis. Ann Surg Oncol. 2018 Mar;25(3):709–19.
Vallejo AN. Immunological hurdles of ageing: Indispensable research of the human model. Ageing Res Rev. 2011 Jul;10(3):315–8.
Mita K, Ito H, Hashimoto M, Murabayashi R, Asakawa H, Nabetani M, et al. Postoperative Complications and Survival after Gastric Cancer Surgery in Patients Older than 80 Years of Age. Journal of Gastrointestinal Surgery. 2013 Dec;17(12):2067–73.
Fantacone ML, Lowry MB, Uesugi SL, Michels AJ, Choi J, Leonard SW, et al. The Effect of a Multivitamin and Mineral Supplement on Immune Function in Healthy Older Adults: A Double-Blind, Randomized, Controlled Trial. Nutrients. 2020 Aug 14;12(8).
Aoyama T, Hara K, Kazama K, Maezawa Y. Clinical Impact of Nutrition and Inflammation Assessment Tools in Gastric Cancer Treatment. Anticancer Res. 2022 Nov;42(11):5167–80.

Details

Primary Language

English

Subjects

Oncologic Surgery , Gastroenterology Surgery , General Surgery

Journal Section

Research Article

Authors

Can Uç ^*
0000-0002-9641-0156
Türkiye

Tolga Girgin
0000-0003-3183-5759
Türkiye

Osman Bozbıyık
0000-0002-1827-2720
Türkiye

Taylan Özgür Sezer
0000-0001-9030-6561
Türkiye

Ozgur Fırat
0000-0002-9683-8945
Türkiye

Muhtar Sinan Ersin
0000-0003-4263-1727
Türkiye

Publication Date

March 12, 2025

Submission Date

June 9, 2024

Acceptance Date

October 30, 2024

Published in Issue

Year 2025 Volume: 64 Number: 1

DOI

https://doi.org/10.19161/etd.1498348

IZ

https://izlik.org/JA85HT47ST

Cite

RIS / Bibtex

Vancouver

1.Can Uç, Tolga Girgin, Osman Bozbıyık, Taylan Özgür Sezer, Ozgur Fırat, Muhtar Sinan Ersin. The perioperative outcomes of gastric cancer surgery in octogenarians. EJM. 2025 Mar. 1;64(1):40-5. doi:10.19161/etd.1498348