Post‐radical gastrectomy long‐term survival and etiologies of mortalities in older adult patients greater than 80 years of age with gastric cancer
Ryota Matsui, Souya Nunobe, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Masaru Hayami, Manabu Ohashi, Takeshi SanoAbstract
Background
Patients aged >80‐years‐old with gastric cancer are commonly excluded from clinical trials, and no consensus exists regarding surgical indications and outcomes in older patients. In this study, we analyzed the post‐gastrectomy long‐term survival and etiologies of mortality in older patients with gastric cancer.
Methods
Patients aged >80‐years‐old with pathological stages I–III primary gastric cancer who undergone radical gastrectomies, between May 2006 and March 2017, were included in the study. Eligible patients were categorized into 3 age cohorts: <85‐, 85–90‐, and >90‐years‐old. The primary outcome was the overall survival. The etiologies of mortalities were compared. Survival curves were compared using the log‐rank test. Prognostic factors were identified by multivariate analysis, using the Cox proportional hazards regression model.
Results
The median follow‐up duration was 59 months. Of the 353 patients, 269 (76.2%), 71 (20.1%), and 13 (3.7%) were categorized into the <85‐, 85–90‐, >90‐years‐old age cohorts, respectively. Older patients had a poorer overall survival (p = 0.003) and statistically significant difference in the other‐cause survival (p < 0.001). The multivariate analysis revealed that age was not an independent prognostic factor for overall or cancer‐specific survival. However, an age >90‐years‐old was an independent prognostic factor for the other‐cause survival.
Conclusions
In patients aged >80‐years‐old with gastric cancer who had undergone gastrectomies, mortalities from other diseases increased with age; while mortalities from gastric cancer did not. An age of ≥90‐years‐old was an independent prognostic factor for mortalities from other diseases.