[Clinical and pathological study of gastric cancer treated without surgery in elderly patients]

To clarify the clinical and pathological characteristics of gastric cancer in the elderly.

Clinical and pathological characteristics of patients who died during 1986-94 with gastric cancer which did not undergo surgery were studied retrospectively. The patients were divided into three groups according to age: A (65-74 years, n = 38), B (75-84 years, n = 77), and C (85 years and over, n = 43).

Borrman type-1 was more frequent in group C and Borrman type-4 was frequent in group B. "Early cancer", protruded type (type I or type IIa) was more frequent in group C. In cases of advanced cancer some patients did not undergo surgery because the cancer was to advanced, and others had concomitant diseases that made surgery risky. In all groups, a few patients refused surgery. In cases of "early cancer", the most reason for not undergoing surgery was a concomitant disease in all groups. Other reasons were general weakness and dementia in group C, second malignancy and dementia in group B, and second malignancy in group A. After advanced cancer was diagnosed, 9.6% survived for 1 year, and 1.7% for 2 years. After early cancer was diagnosed, 50.7% survived for 1 year, 15.2% for 3 years and 7.8% for 4 years. The survival rates did not differ by age. In all age groups, gastric cancer was frequently the main cause of death in patients with advanced cancer, but many patients with "early cancer" died of other causes.