最近１５年間における高齢者胃癌手術症例の臨床病理学的推移

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  • Changes in clinico-pathological findings of the aged patients undergone surgery in these 15 years.

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Recently, in accordance with the increasing ratio of older people in the total pupulation, operations on the aged patients have been increasing. Records were reviewed for 78 patients aged 75 years or older who underwent gastrectomy for gastric cancer at the Frst Department of Surgery, Kyoto Prefectural University of Medicine, between 1973 and 1987. Seventeen cases were in the 1st period (1973-1977), 23 were in the 2nd period (1978-1982), and 38 were in the 3rd period (1983-1987). The results were as follows: 1) The number of aged patients has doubled in these 15 years. 2) The incidence of early gastric cancer has increased significantly from 5.9% to 39.5% (p<0.01), whereas the incidence of advanced gastric cancer decreased remarkably. 3) There was only one operative death in the 15 years. 4) In all three periods, R2 lymphnode dissection was performed in about 60% of all cases. 5) The rateof absolute curative resection was improved from 29.4% to 63.2%. 6) The 5-year survival rate improved significantly from 9.3% to 50.5%.(p<0.01) In conclusion, it seems that improvement in detection of early gastric cancer has contributed to these reults.

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