Gastrectomy prolongs survival in elderly women with gastric cancer

Last Updated: 2016-12-14

By Reuters Staff

NEW YORK (Reuters Health) - Distal gastrectomy for gastric cancer prolongs long-term survival in women 85 years and older, but older men do not appear to derive a survival benefit from the operation, researchers from Japan report.

The number of elderly patients in Japan with gastric cancer is increasing, but it remains unclear whether very old patients with gastric cancer should undergo operation, as their life expectancy is limited.

Dr. Shunji Endo from Higashiosaka City Medical Center and colleagues used propensity score matching in their retrospective analysis of the effects of operation on gastric cancer patients age 85 or older.

Their analysis included 70 patients who underwent curative operative resection and 55 patients who received best supportive care (BSC) alone.

Operative complications affected 19 of 56 (34%) patients who underwent distal gastrectomy, according to the November 25th Surgery online report.

The median overall survival was 57.2 months in the distal gastrectomy group, 20.3 months in the total gastrectomy group, and 16.0 months in the BSC group.

In the propensity score matching analysis of 30 distal gastrectomy and 30 BSC patients, overall survival rates were higher for the distal gastrectomy group at one year (80.0% versus 59.8%, respectively), two years (63.3% versus 23.7%), and five years (47.9% versus 4.8%).

Operation was the only independent prognostic factor for overall survival in a multivariate analysis.

In subgroup analysis, overall survival among male patients did not differ significantly between the distal gastrectomy and BSC groups, but among females, median overall survival was significantly longer after distal gastrectomy than with BSC (66.7 versus 11.6 months).

"The indications for operation in this population should be discussed carefully by the patient, the patient's family, physicians, surgeons, anesthesiologists, and other medical staff based on the patient's wishes, condition, and support system, especially in male patients," the researchers conclude.

Dr. Endo did not respond to a request for comments.

SOURCE: http://bit.ly/2h0IbOD

Surgery 2016.