Mortality for gastric cancer in elderly patients

Background: The aim of this study was to clarify the surgical outcome in elderly patients with gastric cancer. Methods: The clinicopathological features of elderly patients (80 (3.7%), over 80 years, elderly group) were reviewed retrospectively and compared with those of younger patients (2,095 (96.3%), 23-79 years, control group). Results: The elderly group had a significantly higher prevalence of concomitant disease (P < 0.0001), while the prevalence of T1 primary tumor, N0 lymph node metastasis, and stage I was lower (P = 0.0125, P = 0.0004, P < 0.0001). The rates of resected cases and curative operation (R0) were significantly lower in the elderly group (P < 0.0001, P = 0.0021). The mortality from other diseases was 16.3% in elderly patients and 4.4% in control patients (P < 0.0001). The 5-year survival of stage I and stage IV were not significantly different between the two groups (P = 0.1266 and P = 0.2490). The overall survival and disease-specific survival for all patients in the elderly group were significantly lower than those in the control group (P < 0.0001, P = 0.0102). However, disease-specific survival for resected cases was not significantly different between the two groups (P = 0.0725). Conclusions: In elderly patients, the reason for the poor prognosis is the high rate of advanced stage and the high rate of death from other diseases. (C) 2003 Wiley-Liss, Inc.