演題番号 : O85-4
The number of operations for elderly patients with gastric cancer is increasing. However, there are still no clear standards of the risks or strategies for the elderly patients. Therefore, this study was aimed to investigate the risk of gastric cancer operations for the elderly patients.
We retrospectively analyzed 228 consecutive patients over the age of 75 with pStage I-III gastric cancer, who underwent curative gastrectomy from January 2013 through April 2017 at our hospital.
1) Multivariate analysis using the Cox proportional hazard model demonstrated that pStage III (P=0.001, HR 4, CI 1.9-8.5) and ASA score 3 (P=0.047, HR 2.3, CI 1.0-4.9) were the independent factors predicting a shorter OS in the elderly patients.
2) The patients with ASA score 3 presented a significantly poorer overall survival than the patients with ASA score 1-2. (3 year-OS; ASA 1-2 vs. ASA 3, 86.3% vs. 68.2%, P = 0.0069)
3) There was no significant difference in Age, BMI, pStage, Lymph node dissection, the postoperative complications (Clavien Dindo Grade ≥2) rate or surgical procedure between the patients with ASA score 1-2 and the with ASA score 3.
4) In the patients with ASA 3, pStage III (P=0.01, HR 6.7, CI 1.5-47.7) and postoperative complication (P=0.013, HR 5.9, CI 1.5-28.7) were the independent poor prognostic factors for overall survival. However, in the patients with ASA 1-2, pStage III (P=0.004, HR 3.4, CI 1.4-8.0) was the only independent poor prognostic factor for overall survival.
Conclusion: Even in elderly gastric cancer patients with ASA 3, the prognosis may improve without postoperative complications.