The Reasonability of Using Radical Surgery for Improving Survival Rate in Elderly Gastric Cancer Patient

ABSTRACT

Three hundred ninety potentially curative resections for an adenocarcinoma of the stomach were performed in the Surgical Department of Chonbuk National University Hospital between 1991 and 1995. Eighty-nine patients were over 65 years of age, and three hundred-one patients were under 65 years of age. Pre-operative risk factors were statistically common in the over 65-years-old group(p<0.0044). Among the risk factors, pulmonary dysfunction was the most common pre-operative risk factor in both age groups, but diabetes mellitus was statistically significant factor in the under 65-years-old group. The incidence of post-operative complications revealed no statistical difference between two groups, and diarrhea was the most common complication in both groups. The incidence of complications increased when the disease was in an advanced stage and we did an extended operation, including a gastrectomy and a lymphadenectomy, but there was no statistical difference between the two age groups. The 3-year survival rate was higher when we did a curative resection with a subtotal or a total gastrectomy with a D2 lymphadenectomy than when we did non-curative resection, but there was no statistical difference between the two age groups. Hence, a curative resection including a radical gastrectomy with a D2 lymphadenectomy, if it is indicated, is reasonable approach for improving the survival rate in patients with an adenocarcinoma of the stomach, even elderly patients over 65 years of age.