Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association

Background The proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage...

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Veröffentlicht in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2020-03, Vol.23 (2), p.328-338
Hauptverfasser: Nunobe, Souya, Oda, Ichiro, Ishikawa, Takashi, Akazawa, Kohei, Katai, Hitoshi, Isobe, Yoh, Miyashiro, Isao, Tsujitani, Shunichi, Ono, Hiroyuki, Tanabe, Satoshi, Fukagawa, Takeo, Suzuki, Satoshi, Kakeji, Yoshihiro
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container_title Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
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creator Nunobe, Souya
Oda, Ichiro
Ishikawa, Takashi
Akazawa, Kohei
Katai, Hitoshi
Isobe, Yoh
Miyashiro, Isao
Tsujitani, Shunichi
Ono, Hiroyuki
Tanabe, Satoshi
Fukagawa, Takeo
Suzuki, Satoshi
Kakeji, Yoshihiro
description Background The proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer. Methods Data from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes. Results Patients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was 
doi_str_mv 10.1007/s10120-019-01000-3
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However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer. Methods Data from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes. Results Patients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was &lt; 0.7% for any age group, but for those aged ≥ 75 years, the 60-day and 90-day mortality rates were 0.9–2.3% and 1.2–5.1%, respectively. An examination of long-term survival indicated that, as the class of age increased, the 5-year overall survival (OS) was 47.0–93.1% and disease-specific survival (DSS) was 91.4–98.2%, respectively. Although high DSS rates of ≥ 90% were found for all age groups, OS only accounted for ≤ 82% of patients aged ≥ 75 years. Conclusion Among elderly patients with Stage I gastric cancer, deaths due to other diseases were frequently observed in the long term. Thus, for elderly patients, it may be appropriate to reconsider the treatment strategy with respect to the balance between the invasiveness of the treatment and the prognosis.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-019-01000-3</identifier><identifier>PMID: 31451990</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Abdominal Surgery ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Age ; Aged ; Aged, 80 and over ; Cancer Research ; Female ; Follow-Up Studies ; Gastrectomy ; Gastrectomy - mortality ; Gastric cancer ; Gastroenterology ; Geriatrics ; Humans ; Invasiveness ; Japan ; Male ; Medical prognosis ; Medicine ; Medicine &amp; Public Health ; Mortality ; Oncology ; Original Article ; Patients ; Registries - statistics &amp; numerical data ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Surgical Oncology ; Surgical outcomes ; Survival ; Survival Rate</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020-03, Vol.23 (2), p.328-338</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019</rights><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-7465f0d6255182abe3feb124886a279b71ae28f2963cc854c922a5e2d28507403</citedby><cites>FETCH-LOGICAL-c443t-7465f0d6255182abe3feb124886a279b71ae28f2963cc854c922a5e2d28507403</cites><orcidid>0000-0003-3012-5632</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10120-019-01000-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10120-019-01000-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31451990$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nunobe, Souya</creatorcontrib><creatorcontrib>Oda, Ichiro</creatorcontrib><creatorcontrib>Ishikawa, Takashi</creatorcontrib><creatorcontrib>Akazawa, Kohei</creatorcontrib><creatorcontrib>Katai, Hitoshi</creatorcontrib><creatorcontrib>Isobe, Yoh</creatorcontrib><creatorcontrib>Miyashiro, Isao</creatorcontrib><creatorcontrib>Tsujitani, Shunichi</creatorcontrib><creatorcontrib>Ono, Hiroyuki</creatorcontrib><creatorcontrib>Tanabe, Satoshi</creatorcontrib><creatorcontrib>Fukagawa, Takeo</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Kakeji, Yoshihiro</creatorcontrib><creatorcontrib>Registration Committee of the Japanese Gastric Cancer</creatorcontrib><creatorcontrib>the Registration Committee of the Japanese Gastric Cancer</creatorcontrib><title>Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background The proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer. Methods Data from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes. Results Patients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was &lt; 0.7% for any age group, but for those aged ≥ 75 years, the 60-day and 90-day mortality rates were 0.9–2.3% and 1.2–5.1%, respectively. An examination of long-term survival indicated that, as the class of age increased, the 5-year overall survival (OS) was 47.0–93.1% and disease-specific survival (DSS) was 91.4–98.2%, respectively. Although high DSS rates of ≥ 90% were found for all age groups, OS only accounted for ≤ 82% of patients aged ≥ 75 years. Conclusion Among elderly patients with Stage I gastric cancer, deaths due to other diseases were frequently observed in the long term. 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Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nunobe, Souya</au><au>Oda, Ichiro</au><au>Ishikawa, Takashi</au><au>Akazawa, Kohei</au><au>Katai, Hitoshi</au><au>Isobe, Yoh</au><au>Miyashiro, Isao</au><au>Tsujitani, Shunichi</au><au>Ono, Hiroyuki</au><au>Tanabe, Satoshi</au><au>Fukagawa, Takeo</au><au>Suzuki, Satoshi</au><au>Kakeji, Yoshihiro</au><aucorp>Registration Committee of the Japanese Gastric Cancer</aucorp><aucorp>the Registration Committee of the Japanese Gastric Cancer</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association</atitle><jtitle>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</jtitle><stitle>Gastric Cancer</stitle><addtitle>Gastric Cancer</addtitle><date>2020-03-01</date><risdate>2020</risdate><volume>23</volume><issue>2</issue><spage>328</spage><epage>338</epage><pages>328-338</pages><issn>1436-3291</issn><eissn>1436-3305</eissn><abstract>Background The proportion of elderly patients undergoing surgery for gastric cancer is increasing. However, limited number of therapeutic outcomes in the elderly has been reported. Here we examined the surgical results based on a nationwide survey of elderly patients who underwent surgery for Stage I gastric cancer. Methods Data from 68,353 Stage I patients who underwent gastrectomy between 2001 and 2007 were retrospectively collected. The accumulated data were reviewed and analyzed by the Japanese Gastric Cancer Association registration committee. We first classified the patients as those aged ≤ 74 years and ≥ 75 years. We further classified those patients aged ≥ 75 years into groups by 5-year increments to examine their short- and long-term postoperative outcomes. Results Patients aged ≥ 75 years accounted for 46.5%. The 30-day mortality rate was &lt; 0.7% for any age group, but for those aged ≥ 75 years, the 60-day and 90-day mortality rates were 0.9–2.3% and 1.2–5.1%, respectively. An examination of long-term survival indicated that, as the class of age increased, the 5-year overall survival (OS) was 47.0–93.1% and disease-specific survival (DSS) was 91.4–98.2%, respectively. Although high DSS rates of ≥ 90% were found for all age groups, OS only accounted for ≤ 82% of patients aged ≥ 75 years. Conclusion Among elderly patients with Stage I gastric cancer, deaths due to other diseases were frequently observed in the long term. Thus, for elderly patients, it may be appropriate to reconsider the treatment strategy with respect to the balance between the invasiveness of the treatment and the prognosis.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>31451990</pmid><doi>10.1007/s10120-019-01000-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-3012-5632</orcidid><oa>free_for_read</oa></addata></record>
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subjects Abdominal Surgery
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Age
Aged
Aged, 80 and over
Cancer Research
Female
Follow-Up Studies
Gastrectomy
Gastrectomy - mortality
Gastric cancer
Gastroenterology
Geriatrics
Humans
Invasiveness
Japan
Male
Medical prognosis
Medicine
Medicine & Public Health
Mortality
Oncology
Original Article
Patients
Registries - statistics & numerical data
Retrospective Studies
Risk Factors
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Surgery
Surgical Oncology
Surgical outcomes
Survival
Survival Rate
title Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association
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