Surgical outcomes after gastrectomy in very elderly patients with gastric cancer

Surg Today. 2018 Aug;48(8):773-782. doi: 10.1007/s00595-018-1651-x. Epub 2018 Mar 13.


Purpose: Whether or not gastrectomy is feasible for very elderly gastric cancer patients is unclear. This study aimed to clarify the feasibility and safety of surgical treatment for patients in this age group.

Method: The study included 55 very elderly patients with resectable gastric cancer who underwent gastrectomy (≥ 85 years of age; very-E group). The surgical outcomes were compared with those of 611 elderly patients (75-84 years old; E group).

Results: Female sex, a poor physical and performance status, and a low serum albumin level patients were more frequent in the very-E group than in the E group. Lymphadenectomy was less aggressive in the very-E group than in the E group (P < 0.001). The overall postoperative complication rate was not significantly different between the groups (46 vs 33%; P = 0.073). A multivariate analysis to predict the overall survival identified male sex (hazard ratio 1.75, 95% confidence interval 1.30-2.36), low body mass index (2.19, 1.52-3.16), poor performance status (2.14, 1.60-2.86), low serum albumin level (1.84, 1.37-2.48), and advanced tumor stage (1.71, 1.29-2.27) but not age (1.31, 0.84-2.03) as independent prognostic factors.

Conclusion: Chronological age alone is not a contraindicative factor for gastrectomy in very elderly patients.

Keywords: Elderly; Gastrectomy; Gastric Cancer; Prognostic Factors; Survival.

MeSH terms

  • Age Factors
  • Aged, 80 and over
  • Body Mass Index
  • Feasibility Studies
  • Female
  • Gastrectomy* / mortality
  • Humans
  • Lymph Node Excision
  • Male
  • Neoplasm Staging
  • Postoperative Complications / epidemiology
  • Prognosis
  • Serum Albumin
  • Sex Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Survival Rate
  • Treatment Outcome


  • Serum Albumin