Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2017; 23(7): 1215-1223
Published online Feb 21, 2017. doi: 10.3748/wjg.v23.i7.1215
Surgery for gastric cancer patients of age 85 and older: Multicenter survey
Hirotaka Konishi, Daisuke Ichikawa, Hiroshi Itoh, Kenichiro Fukuda, Naoki Kakihara, Manabu Takemura, Kaori Okugawa, Kiyoshi Uchiyama, Masashi Nakata, Hiroshi Nishi, Toshiyuki Kosuga, Shuhei Komatsu, Kazuma Okamoto, Eigo Otsuji
Hirotaka Konishi, Daisuke Ichikawa, Toshiyuki Kosuga, Shuhei Komatsu, Kazuma Okamoto, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
Hiroshi Itoh, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Yosa-gun, Kyoto 629-2261, Japan
Kenichiro Fukuda, Department of Surgery, Saiseikai Shigaken Hospital, Ritto, Shiga 520-3046, Japan
Naoki Kakihara, Department of Surgery, Japanese Red Cross Kyoto Daini Hospital, Kamigyo-ku, Kyoto 602-8026, Japan
Manabu Takemura, Department of Surgery, Osaka General Hospital of West Japan Railway Company, Abeno-ku, Osaka 545-0053, Japan
Kaori Okugawa, Department of Surgery, Omihachiman Community Medical Center, Omihachiman, Shiga 523-0082, Japan
Kiyoshi Uchiyama, Department of Surgery, Kyoto Okamoto Memorial Hospital, Kumiyama-cho, Kyoto 613-0034, Japan
Masashi Nakata, Department of Surgery, Kyoto Yamashiro General Medical Center, Kizugawa, Kyoto 619-0214, Japan
Hiroshi Nishi, Department of Surgery, Saiseikai Kyoto Hospital, Nagaokakyo, Kyoto 617-0814, Japan
Author contributions: Konishi H and Itoh H contributed equally to this study; Konishi H, Ichikawa D, Itoh H and Otsuji E designed the research; Konishi H, Ichikawa D, Itoh H, Fukuda K, Kakihara N, Takemura M, Okugawa K, Uchiyama K, Nakata M, Nishi H, Kosuga T, Komatsu S and Okamoto K treated the patients and collected the data; Konishi H, Ichikawa D and Itoh H analyzed the data; Konishi H, Ichikawa D, Itoh H and Otsuji E wrote the manuscript.
Institutional review board statement: The study was reviewed and approved by the Faculty of Science Ethics Committee at Kyoto Prefectural University of Medicine (RBMR-C-179).
Informed consent statement: All study participants provided informed written consent prior to their treatments and study enrollment.
Conflict-of-interest statement: All authors declare no conflict of interest related to this study or its publication.
Data sharing statement: The technical appendix, statistical code and dataset are available from Hirotaka Konishi at h-koni7@koto.kpu-m.ac.jp.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daisuke Ichikawa, MD, PhD, Assistant Professor, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kajii-cho 465, Kamigyo-ku, Kyoto 602-8566, Japan. ichikawa@koto.kpu-m.ac.jp
Telephone: +81-75-2515527 Fax: +81-75-2515522
Received: October 19, 2016
Peer-review started: October 20, 2016
First decision: November 9, 2016
Revised: November 26, 2016
Accepted: January 11, 2017
Article in press: January 11, 2017
Published online: February 21, 2017
Core Tip

Core tip: Therapeutic opportunities for elderly gastric cancer (GC) patients have expanded. This multicenter study investigated surgical therapies for GC patients of age 85 or older. Cancer-specific and overall survival rates were 100% and 56% in cStage I. The factors of pT3/4 and limited lymphadenectomy were predictive of worse prognosis. Cancer-specific survival in cStage II with radical lymphadenectomy was significantly better, but did not significantly benefit cStage III. Only cerebrovascular disease was related with limited lymphadenectomy. Non-cancer-specific death was not negligible, particularly in cStage I, and gastrectomy with radical lymphadenectomy appeared to be an effective treatment for cStage II elderly patients.