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Yaşlı hastalarda mide kanseri cerrahisinin perioperatif sonuçlarının değerlendirilmesi

Yıl 2025, Cilt: 64 Sayı: 1, 40 - 45, 12.03.2025

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

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

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

yaşlı hasta mide kanser cerrahisi perioperatif cerrahi sonuçlar

Kaynakça

  • 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.

The perioperative outcomes of gastric cancer surgery in octogenarians

Yıl 2025, Cilt: 64 Sayı: 1, 40 - 45, 12.03.2025

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

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

Öz

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.

Anahtar Kelimeler

octogenerian gastric surgery perioperative outcomes gastric cancer

Kaynakça

  • 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.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi Onkoloji, Gastroenteroloji Cerrahisi, Genel Cerrahi
Bölüm Araştırma Makaleleri
Yazarlar

Can Uç 0000-0002-9641-0156

Tolga Girgin 0000-0003-3183-5759

Osman Bozbıyık 0000-0002-1827-2720

Taylan Özgür Sezer 0000-0001-9030-6561

Ozgur Fırat 0000-0002-9683-8945

Muhtar Sinan Ersin 0000-0003-4263-1727

Yayımlanma Tarihi 12 Mart 2025
Gönderilme Tarihi 9 Haziran 2024
Kabul Tarihi 30 Ekim 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 64 Sayı: 1

Kaynak Göster

Vancouver Uç C, Girgin T, Bozbıyık O, Sezer TÖ, Fırat O, Ersin MS. The perioperative outcomes of gastric cancer surgery in octogenarians. ETD. 2025;64(1):40-5.
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