Details der Publikation - The comparison of prognoses between total and distal gastrectomy for gastric cancer in elderly patients ≥ 80 years old

The comparison of prognoses between total and distal gastrectomy for gastric cancer in elderly patients ≥ 80 years old

Purpose In Japan, the number of distal gastrectomy for patients ≥ 80 years old is increasing, whereas that of total gastrectomy is decreasing. Surgeons seem to avoid total gastrectomy for elderly patients. Total gastrectomy is reported to have a poorer prognosis than distal gastrectomy, and postoperative pneumonia may be involved in the cause. Methods The medical records of 39 and 108 patients ≥ 80 years old who underwent total and distal gastrectomy, respectively, at 2 affiliated institutions between 2010 and 2019 were retrospectively reviewed. Prognoses were compared between the two groups, focusing on death from pneumonia. Results The median overall survival time after total and distal gastrectomy was 21.3 and 74.1 months, respectively, with a significantly poorer prognosis after total gastrectomy than after distal gastrectomy (p < 0.01, hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.37–3.53). The gastric cancer-specific survival time was significantly worse after total gastrectomy than after distal gastrectomy (p < 0.01, HR 2.73, 95% CI 1.29–5.79). The pneumonia-specific survival time was also significantly worse after total gastrectomy than after distal gastrectomy (p = 0.01, HR 3.44, 95% CI 1.25–9.48). Conclusions Patients who underwent total gastrectomy had a poorer prognosis than those who underwent distal gastrectomy, because many patients died of pneumonia early after total gastrectomy..

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:53
Enthalten in:	Surgery today - 53(2022), 5 vom: 23. Nov., Seite 569-577

Sprache:	Englisch

Beteiligte Personen:	Endo, Shunji [VerfasserIn] Yamatsuji, Tomoki [VerfasserIn] Fujiwara, Yoshinori [VerfasserIn] Higashida, Masaharu [VerfasserIn] Kubota, Hisako [VerfasserIn] Tanaka, Hironori [VerfasserIn] Ito, Yoshitomo [VerfasserIn] Okada, Toshimasa [VerfasserIn] Yoshiatsu, Kazuhiko [VerfasserIn] Ueno, Tomio [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

BKL:	44.65$jChirurgie
Themen:	80 and over Aged Gastrectomy Pneumonia Stomach neoplasms

RVK:	RVK Klassifikation ELIB24

Anmerkungen:	© The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:	10.1007/s00595-022-02599-0

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2134494549

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520			\|a Purpose In Japan, the number of distal gastrectomy for patients ≥ 80 years old is increasing, whereas that of total gastrectomy is decreasing. Surgeons seem to avoid total gastrectomy for elderly patients. Total gastrectomy is reported to have a poorer prognosis than distal gastrectomy, and postoperative pneumonia may be involved in the cause. Methods The medical records of 39 and 108 patients ≥ 80 years old who underwent total and distal gastrectomy, respectively, at 2 affiliated institutions between 2010 and 2019 were retrospectively reviewed. Prognoses were compared between the two groups, focusing on death from pneumonia. Results The median overall survival time after total and distal gastrectomy was 21.3 and 74.1 months, respectively, with a significantly poorer prognosis after total gastrectomy than after distal gastrectomy (p < 0.01, hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.37–3.53). The gastric cancer-specific survival time was significantly worse after total gastrectomy than after distal gastrectomy (p < 0.01, HR 2.73, 95% CI 1.29–5.79). The pneumonia-specific survival time was also significantly worse after total gastrectomy than after distal gastrectomy (p = 0.01, HR 3.44, 95% CI 1.25–9.48). Conclusions Patients who underwent total gastrectomy had a poorer prognosis than those who underwent distal gastrectomy, because many patients died of pneumonia early after total gastrectomy.
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The comparison of prognoses between total and distal gastrectomy for gastric cancer in elderly patients ≥ 80 years old

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