Prognostic Factors in Patients Aged ≥80 Years With Stage II-III Gastric Cancer

Area of Science:

• Oncology
• Geriatric Surgery
• Surgical Outcomes

Background:

• Gastric cancer (GC) incidence rises in aging populations.
• Optimal surgical strategies for elderly GC patients (≥80 years) with advanced disease are unclear due to frailty and comorbidities.
• This study investigates prognostic factors in very elderly patients with stage II-III GC.

Purpose of the Study:

• To identify prognostic factors for overall survival (OS) and cancer-specific survival (CSS) in patients aged ≥80 years with stage II-III GC.
• To evaluate the impact of clinicopathological, nutritional, and surgical factors on outcomes.
• To determine the optimal surgical approach for this demographic.

Main Methods:

• Retrospective analysis of 57 patients (≥80 years) with stage II-III GC undergoing curative gastrectomy (2013-2023).
• Evaluation of clinicopathological data, nutritional indices (PNI, CONUT, GNRI, SMI), and surgical factors.
• Survival analysis using Kaplan-Meier and Cox proportional hazards models.

Main Results:

• Total gastrectomy (TG) was identified as an independent predictor of poor OS (HR=3.48, p=0.0218).
• Factors predicting poor OS included low BMI, high CONUT score, TG, and severe postoperative complications.
• While OS was worse in the TG group, no significant difference in CSS was observed between TG and non-TG groups.

Conclusions:

• Total gastrectomy is an independent predictor of reduced overall survival in very elderly patients with stage II-III gastric cancer.
• Patient-related factors and the extent of surgery significantly influence prognosis in this population.
• Findings suggest a need for careful consideration of surgical approach in elderly GC patients.