Radical surgical treatment of elderly patients with gastric cancer

Abstract

To analyze the early results of radical surgery for gastric cancer in patients > 75 years. In the period between Jan. 2013 and June 2015 there were 25 radical operations in elderly (≥ 75 years) patients with gastric cancer. The following outcomes are presented: bloodloss, duration of surgery, mortality and morbidiy according to Dindo-Clavien classification, length of stay. There were 12 total and 13 distal gastrectomies, including 8 laparoscopic procedures (2 - total laparoscopic gastrectomies), all with D2 lymph node dissection. Mean bloodloss constituted 50±64 ml (0-300 ml), mean duration of surgery 220±70 min (140-360 min). There was no in-hospital mortality, but one patient died 2 weeks after discharge because of an unclear intraluminal bleeding. Mild complications (Dindo-Clavien I-II) were found in 6 patients, severe in 11 patients. In 6 patients repeated laparotomies were necessary. Mean length-of-stay constituted 13±17 (5-63) days. Radical gastric cancer surgery in the elderly patients is feasible. A prerequisite is a thorough pre-operative examination. This type of surgery shall be practiced in highly specialized centers after detailled control of patients’ comorbidity.