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 |
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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 |
format | Article |
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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 < 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 & 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</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 < 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><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer Research</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastrectomy</subject><subject>Gastrectomy - mortality</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Invasiveness</subject><subject>Japan</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Registries - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Survival Rate</subject><issn>1436-3291</issn><issn>1436-3305</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1TAQhS0Eoj_wAiyQJTZsAuNxnJ9ldVXaokosCmvL15mkrpL4Yjuq7iPw1vg2tyCxYGGNpfnOmdEcxt4J-CQA6s9RgEAoQLT5AUAhX7BTUcqqkBLUy-c_tuKEncX4ACBUK6rX7ESKUom2hVP2624Jg7Nm5H5J1k8Uue85jR2Fcc93JjmaU-SPLt3zu2QG4jd8MDEFZ7k1s6XA--Annu6Jz5n286PriAcaXIb2B7ND66vZmZki8aujdrNqL2L01j3p3rBXvRkjvT3Wc_bjy-X3zXVx--3qZnNxW9iylKmoy0r10FWolGjQbEn2tBVYNk1lsG63tTCETY9tJa1tVGlbRKMIO2wU1CXIc_Zx9d0F_3OhmPTkoqVxzAv6JWrERgioa1AZ_fAP-uCXMOftNErV1If7Y6ZwpWzwMQbq9S64yYS9FqAPQek1KJ2D0k9BaZlF74_Wy3ai7o_kOZkMyBWIuTUPFP7O_o_tb_LTngo</recordid><startdate>20200301</startdate><enddate>20200301</enddate><creator>Nunobe, Souya</creator><creator>Oda, Ichiro</creator><creator>Ishikawa, Takashi</creator><creator>Akazawa, Kohei</creator><creator>Katai, Hitoshi</creator><creator>Isobe, Yoh</creator><creator>Miyashiro, Isao</creator><creator>Tsujitani, Shunichi</creator><creator>Ono, Hiroyuki</creator><creator>Tanabe, Satoshi</creator><creator>Fukagawa, Takeo</creator><creator>Suzuki, Satoshi</creator><creator>Kakeji, Yoshihiro</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3012-5632</orcidid></search><sort><creationdate>20200301</creationdate><title>Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-7465f0d6255182abe3feb124886a279b71ae28f2963cc854c922a5e2d28507403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer Research</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastrectomy</topic><topic>Gastrectomy - mortality</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Invasiveness</topic><topic>Japan</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Registries - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & 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 < 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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