高齢者胃癌手術のｒｉｓｋ　ｆａｃｔｏｒ

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  • Risk Factors of Stomach Cancer Resection in the Elderly.

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Eight hundred twenty-three gastric cancer patients who underwent gastrectomy between 1985 and 1995, when we aggressively treated even advanced stomach cnacer in aged patients were evaluated. These cases were devided into 3 groups according to age. One group was 69 years and younger (n=482), the second group was between 70 and 79 (n=258), and the third group was 80 years and older (n=83). The relationship between patient's risk factors and hospital mortality rate, showed that there are specific risk factors in gastrectomy for aged patients. According to the hospital mortality rate, the risk factors were as follows: (1) Those related to the preoperative status were PS (Performance Status) 3 or above, a decreased will to live including dementia, and inability to walk. (2) Those related to preoperative complications were respiratory disorders, hypoproteinemia and anemia. (3) Those related to surgical issues were H, P, N4 factor and total gastrectomy. In the group 69 years and younger, these risk factors did not influence the hospital mortality rate. The group between 70 and 79, only the risk (1) increased the hospital mortality rate. For the group 80 years and older, in these risk factor positive cases, the hospital mortality rate was high (1) 30.8%, (2) 21.4-27.3%, (3) 16.7-50.0%, while in the risk factor negative cases, it was (1) 5.7%, (2) 7.5%-10.5%, (3) 1.9%, showing a significant difference.

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