Comparison of Gastric Cancer Surgery between Patients aged >80 Years and <79 Years: Complications and Multivariate Analysis of Prognostic Factors

(Background/Aims: To evaluate the clinicopathological features and results of surgery for gastric cancer in elderly patients aged >80 years relative to those aged <79 years, and to recommend the appropriate surgical treatment for elderly patients. Methodology: A total of 332 patients with gastric cancer who underwent gastrectomy in our department between 2002 and 2012 were evaluated. Of these, 81 were aged >80 years (Group A) and 251 were aged <79 years (Group B). We compared surgical outcomes and survival in these two groups. Results: Postopeartive complications were associated with preoperative cormorbid disease(p<0.01). D2 and R0 resection was common in GroupB (p<0.01). Respiratory complications and hospital deaths were higher in Group A than in Group B. Overall survival (OS) was significantly lower in Group A than in Group B. Regarding Stage I disease, OS was significantly lower in Group A; however, cause-specific survival was similar between the two groups. Multivariate analysis showed that radicality and postoperative complications were independent prognostic factors for OS in elderly gastric cancer patients. Conclusion: These results indicate that postoperative respiratory complications and other causes of death worsened the prognosis of elderly. Preoperative accurate judgment of co-morbid disease, meticulous postoperative management and follow up might be improved survival of gastric cancer in elderly.