Predictors of postoperative complications in elderly and oldest old patients with gastric cancer
| Autor: | Takehiro Takama, Yasuyuki Suzuki, Masao Fujiwara, Hisashi Usuki, Keiichi Okano, Shintaro Akamoto, Akihiro Kondo |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Blood Loss Surgical Postoperative Complications Elderly persons Blood loss Gastrectomy Risk Factors Stomach Neoplasms Surgical oncology Internal medicine medicine Humans Survival rate Aged Aged 80 and over business.industry Incidence (epidemiology) digestive oral and skin physiology Gastroenterology Cancer General Medicine Oldest old medicine.disease digestive system diseases Survival Rate Oncology Lymph Node Excision Female Morbidity business Glomerular Filtration Rate Abdominal surgery |
| Zdroj: | Gastric Cancer. 18:653-661 |
| ISSN: | 1436-3305 1436-3291 |
| DOI: | 10.1007/s10120-014-0387-6 |
| Popis: | The incidence of gastric cancer has been increasing among elderly persons in Japan. This study aimed to clarify risk factors for postoperative complications in oldest old patients with gastric cancer.One-hundred ninety patients more than 75 years old with gastric cancer underwent gastrectomy between 2000 and 2011. Patients were classified into two groups: group A included 29 patients who were 85 years or older (oldest old patients), and group B included 161 patients who were 75-84 years of age. Perioperative parameters associated with complications were compared in each group.The preoperative estimated glomerular filtration rate was significantly lower in group A (p = 0.03). The two groups significantly differed in performance status (p = 0.018). Patients in group A received a lesser extent of lymph node dissection and had fewer lymph nodes excised. As a result, the duration of the operation was significantly shorter in group A. There were no significant differences in the frequency or grade of total complications or mortality between the two groups. Operative hemorrhage (300 ml) and Hiroshima POSSUM (predicted morbidity risk40) were risk factors in both groups A and B; the risk factors of preoperative serum albumin level and prognostic nutritional index (PNI) were specific to group A.Adjustments to the extent of surgery among oldest old patients most likely reduces the incidence of postoperative complications in this group. Preoperative serum albumin level and PNI are significant predictors of postoperative complications in oldest old patients with gastric cancer. |
| Databáze: | OpenAIRE |
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