Surgical Outcomes in Elderly Gastric Cancer Patients
Summary
Surgical management of gastric cancer in patients aged 65 years or older presents unique challenges owing to age-related physiological decline, increased comorbidity burden and varying degrees of frailty. Contemporary series demonstrate that curative gastrectomy can achieve comparable long-term survival in selected elderly individuals when perioperative assessment and tailored surgical strategies are employed. Minimally invasive approaches, such as laparoscopic gastrectomy, are associated with reduced blood loss, faster recovery and lower complication rates, yet often involve longer operating times. The extent of lymphadenectomy must balance oncological benefit against the risk of postoperative pneumonia and other morbidities in frail patients. Adjuvant chemotherapy confers survival advantage even in octogenarians, provided that treatment tolerance is carefully evaluated. Multidisciplinary care incorporating comprehensive geriatric assessment, optimisation of comorbid conditions and early mobilisation programmes underpins safe recovery and improves overall survival outcomes globally.
Research from Nature Portfolio
Emerging evidence indicates that sex differences influence postoperative complications and survival after gastrectomy in elderly cohorts. In one large series of patients aged 75 years or older undergoing curative resection, male sex emerged as an independent risk factor for both postoperative morbidity and poorer prognosis. Upper-third tumour location and higher incidence of comorbidities among men contributed to these findings. Crucially, patients at high risk of complications demonstrated improved three-year survival when undergoing limited rather than standard lymphadenectomy, suggesting that personalised surgical extent can mitigate adverse outcomes in vulnerable subgroups.
Surgical Outcomes in Elderly Gastric Cancer Patients publication trend
The graph below shows the total number of articles in surgical outcomes in elderly gastric cancer patients across all publications each year (not limited to Nature Index journals).
Technical terms
Gastrectomy: Surgical removal of part or all of the stomach.
D2 lymphadenectomy: Extended removal of perigastric and adjacent lymph nodes during gastrectomy.
Comorbidity index: A scoring system that quantifies additional diseases or conditions affecting patient prognosis.
Propensity score matching: A statistical method used to balance patient characteristics between treatment groups in observational studies.
Clavien–Dindo classification: A system for grading the severity of postoperative complications.
References
- Adjuvant Chemotherapy in Older Patients with Gastric Cancer: A Population-Based Cohort Study. Cancers (2023).
- Differences of clinical features and outcomes between male and female elderly patients in gastric cancer. Scientific Reports (2023).
- Gastrıc cancer surgery in elderly patients: promising results from a mid-western population. BMC Geriatrics (2023).
- Laparoscopic gastrectomy versus open gastrectomy for elderly patients with gastric cancer: a systematic review and meta-analysis. World Journal of Surgical Oncology (2016).
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