Published online Jun 15, 2017. doi: 10.4251/wjgo.v9.i6.257
Peer-review started: December 31, 2016
First decision: February 4, 2017
Revised: February 24, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: June 15, 2017
To evaluate clinicopathological features and surgical outcomes of gastric cancer in elderly and non-elderly patients after inverse probability of treatment weighting (IPTW) method using propensity score.
We enrolled a total of 448 patients with histologically confirmed primary gastric carcinoma who received gastrectomies. Of these, 115 patients were aged > 80 years old (Group A), and 333 patients were aged < 79 years old (Group B). We compared the surgical outcomes and survival of the two groups after IPTW.
Postoperative complications, especially respiratory complications and hospital deaths, were significantly more common in Group A than in Group B (P < 0.05). Overall survival (OS) was significantly lower in Group A patients than in Group B patients. Among the subset of patients who had pathological Stage I disease, OS was significantly lower in Group A (P < 0.05) than Group B, whereas cause-specific survival was almost equal in the two groups. In multivariate analysis, pathological stage, histology, and extent of lymph node dissection were independent prognostic values for OS.
When the gastrectomy was performed in gastric cancer patients, we should recognized high mortality and comorbidities in that of elderly. More extensive lymph node dissection might improve prognoses of elderly gastric cancer patients.
Core tip: Inverse probability of treatment weighting (IPTW) attempts to reduce the bias due to confounding variables in estimates of treatment effects. In the present study, we compared the surgical outcomes and survival of elderly gastric cancer patients with that of general population after IPTW. The overall survival of pStage I gastric cancer patients in elderly was lower survival due to death of other diseases. We found that extent of lymph nodes dissection were independent prognostic factors. When the gastrectomy was performed in gastric cancer patients, we should recognized high mortality and comorbidities in that of elderly. This study was reviewed and approved by Nara Hospital, Kindai University review board on human research.