Gastric cancer in elderly patients--results of surgical treatment

Between 1972 and 1984, a total of 848 patients underwent gastrectomies for gastric cancer. One hundred and thirty-nine patients (16%) were aged 70 and over (elderly group), the remaining 709 being under 70 (control group). The operative morbidity and mortality rates were 29.5% and 4.3% in the elderly group, as compared with 23.0% and 1.8% in the controls. The 5-year survival rate was 47.2 +/- 5.3% in the former and 53.9 +/- 2.4% in the latter. In neither comparison was the difference statistically significant. The mortality rate after total gastrectomy in the elderly group was 8.6% for the overall period, but it has reduced to 5.3% in the past five years. These data would seem to justify a liberalized indication for radical surgery in elderly patients. In the elderly group, the mean operating time and the amount of bleeding in the operative-death patients significantly exceeded those in the surviving patients. Non-curative resection in elderly patients could not be generally accepted, since the mean survival time was only 11 months, with high morbidity (40.5%) and mortality rates (8.1%).