GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?

ABSTRACT Background: The octogenarian population is expanding worldwide and demand for gastrectomy due to gastric cancer in this population is expected to grow. However, the outcomes of surgery with curative intent in this age group are poorly reported and it is unclear what matters most to survival: age, clinical status, disease´s stage, or the extent of the surgery performed. Aim: Evaluate the results of gastrectomy in octogenarians with gastric cancer and to verify the factors related to survival. Methods: From prospective database, patients aged 80 years or older with histologically confirmed adenocarcinoma who had undergone gastrectomy with curative intent were selected. Factors related to postoperative complications and survival were studied. Results: Fifty-one patients fulfilled the inclusion criteria. A total of 70.5% received subtotal gastrectomy and in 72.5% D1 lymphadenectomy was performed. Twenty-five (49%) had complications, in eleven major complications occurred (seven of these were clinical complications). Hospital length of stay was longer (8.5 vs. 17.8 days, p=0.002), and overall survival shorter (median of 1.4 vs. 20.5 months, p=0.009) for those with complications. D2 lymphadenectomy and the presence of postoperative complications were independent factors for worse overall survival. Conclusion: Octogenarians undergoing gastrectomy with curative intent have high risk for postoperative clinical complications. D1 lymphadenectomy should be the standard of care in these patients.

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Main Authors: SILVA,Francisco Diogo Almeida, PEREIRA,Marina Alessandra, RAMOS,Marcus Fernando Kodama Pertille, RIBEIRO-JUNIOR,Ulysses, ZILBERSTEIN,Bruno, CECCONELLO,Ivan, DIAS,Andre Roncon
Format: Digital revista
Language:English
Published: Colégio Brasileiro de Cirurgia Digestiva 2020
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000400303
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spelling oai:scielo:S0102-672020200004003032021-01-21GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?SILVA,Francisco Diogo AlmeidaPEREIRA,Marina AlessandraRAMOS,Marcus Fernando Kodama PertilleRIBEIRO-JUNIOR,UlyssesZILBERSTEIN,BrunoCECCONELLO,IvanDIAS,Andre Roncon Stomach neoplasms Gastrectomy Aged, 80 and over Aged Survival ABSTRACT Background: The octogenarian population is expanding worldwide and demand for gastrectomy due to gastric cancer in this population is expected to grow. However, the outcomes of surgery with curative intent in this age group are poorly reported and it is unclear what matters most to survival: age, clinical status, disease´s stage, or the extent of the surgery performed. Aim: Evaluate the results of gastrectomy in octogenarians with gastric cancer and to verify the factors related to survival. Methods: From prospective database, patients aged 80 years or older with histologically confirmed adenocarcinoma who had undergone gastrectomy with curative intent were selected. Factors related to postoperative complications and survival were studied. Results: Fifty-one patients fulfilled the inclusion criteria. A total of 70.5% received subtotal gastrectomy and in 72.5% D1 lymphadenectomy was performed. Twenty-five (49%) had complications, in eleven major complications occurred (seven of these were clinical complications). Hospital length of stay was longer (8.5 vs. 17.8 days, p=0.002), and overall survival shorter (median of 1.4 vs. 20.5 months, p=0.009) for those with complications. D2 lymphadenectomy and the presence of postoperative complications were independent factors for worse overall survival. Conclusion: Octogenarians undergoing gastrectomy with curative intent have high risk for postoperative clinical complications. D1 lymphadenectomy should be the standard of care in these patients.info:eu-repo/semantics/openAccessColégio Brasileiro de Cirurgia DigestivaABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.33 n.4 20202020-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000400303en10.1590/0102-672020200004e1552
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author SILVA,Francisco Diogo Almeida
PEREIRA,Marina Alessandra
RAMOS,Marcus Fernando Kodama Pertille
RIBEIRO-JUNIOR,Ulysses
ZILBERSTEIN,Bruno
CECCONELLO,Ivan
DIAS,Andre Roncon
spellingShingle SILVA,Francisco Diogo Almeida
PEREIRA,Marina Alessandra
RAMOS,Marcus Fernando Kodama Pertille
RIBEIRO-JUNIOR,Ulysses
ZILBERSTEIN,Bruno
CECCONELLO,Ivan
DIAS,Andre Roncon
GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
author_facet SILVA,Francisco Diogo Almeida
PEREIRA,Marina Alessandra
RAMOS,Marcus Fernando Kodama Pertille
RIBEIRO-JUNIOR,Ulysses
ZILBERSTEIN,Bruno
CECCONELLO,Ivan
DIAS,Andre Roncon
author_sort SILVA,Francisco Diogo Almeida
title GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
title_short GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
title_full GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
title_fullStr GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
title_full_unstemmed GASTRECTOMY IN OCTOGENARIANS WITH GASTRIC CANCER: IS IT FEASIBLE?
title_sort gastrectomy in octogenarians with gastric cancer: is it feasible?
description ABSTRACT Background: The octogenarian population is expanding worldwide and demand for gastrectomy due to gastric cancer in this population is expected to grow. However, the outcomes of surgery with curative intent in this age group are poorly reported and it is unclear what matters most to survival: age, clinical status, disease´s stage, or the extent of the surgery performed. Aim: Evaluate the results of gastrectomy in octogenarians with gastric cancer and to verify the factors related to survival. Methods: From prospective database, patients aged 80 years or older with histologically confirmed adenocarcinoma who had undergone gastrectomy with curative intent were selected. Factors related to postoperative complications and survival were studied. Results: Fifty-one patients fulfilled the inclusion criteria. A total of 70.5% received subtotal gastrectomy and in 72.5% D1 lymphadenectomy was performed. Twenty-five (49%) had complications, in eleven major complications occurred (seven of these were clinical complications). Hospital length of stay was longer (8.5 vs. 17.8 days, p=0.002), and overall survival shorter (median of 1.4 vs. 20.5 months, p=0.009) for those with complications. D2 lymphadenectomy and the presence of postoperative complications were independent factors for worse overall survival. Conclusion: Octogenarians undergoing gastrectomy with curative intent have high risk for postoperative clinical complications. D1 lymphadenectomy should be the standard of care in these patients.
publisher Colégio Brasileiro de Cirurgia Digestiva
publishDate 2020
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000400303
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