Outcomes of octogenarians undergoing gastrectomy performed for malignancy

Area of Science:

• Surgical Oncology
• Geriatric Surgery
• Gastrointestinal Oncology

Background:

• Limited data exists on perioperative outcomes for octogenarians undergoing gastric cancer surgery due to small sample sizes.
• Investigating treatment variations and outcomes in elderly patients (≥80 years) is essential.

Purpose of the Study:

• To determine the outcomes of gastrectomy in octogenarians with gastric cancer.
• To analyze treatment variations in relation to advanced age.

Main Methods:

• Utilized the National Surgical Quality Improvement Program database (2005-2011).
• Identified patients undergoing gastrectomy for malignancy using ICD-9 and CPT codes.
• Compared outcomes between octogenarians (≥80 years) and non-octogenarians (<80 years).

Main Results:

• Octogenarians (487 cases) showed higher 30-day mortality (7.2% vs. 2.5%) and major complications (31.4% vs. 25.5%) compared to non-octogenarians (2104 cases).
• Fewer octogenarians underwent total gastrectomy (24.0% vs. 43.2%) and extended lymphadenectomy (10.1% vs. 17.4%).
• Multivariate analysis confirmed age ≥80 years as a predictor for major complications (OR 1.3) and increased mortality (OR 3.0).

Conclusions:

• Advanced age (≥80 years) is associated with poorer outcomes after gastrectomy for gastric cancer.
• Thorough staging is vital to avoid unnecessary surgeries in this demographic.
• Pre-operative optimization is critical for octogenarian patients undergoing gastrectomy.