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Background <p>The proportion of elderly patients among those diagnosed with gastric cancer (GC) is increasing worldwide. Given that physiological reserves are often diminished in this population, reliable tools for preoperative risk stratification are essential to inform therapeutic decision-making. Lung age, a spirometry-derived clinical parameter, has been associated with postoperative outcomes in some malignancies; however, its relevance in GC remains unclear. This study retrospectively evaluated the prognostic significance of lung age in elderly GC patients undergoing curative gastrectomy.</p> Methods <p>A total of 155 GC patients aged ≥ 70 years who underwent R0 gastrectomy were analyzed. The age gap (AG), defined as the difference between lung age and chronological age, was examined in relation to clinicopathological characteristics, postoperative complications, and survival outcomes.</p> Results <p>AG was significantly associated with postoperative complications. In univariate analyses, AG showed significant associations with overall survival (OS) and non–GC-related mortality, but not with cancer-specific survival. In multivariate analysis, AG was not an independent predictor of OS; however, it remained an independent predictor of non–GC-related death, whether analyzed as a dichotomous variable (hazard ratio [HR] 3.14, 95% confidence interval [CI] 1.33–7.38, <i>p</i> = 0.009) or as a continuous variable (HR 1.25 per 10-year increase, 95% CI 1.01–1.54, <i>p</i> = 0.036).</p> Conclusion <p>The discrepancy between lung and chronological age may serve as a useful predictor of long-term outcomes, particularly non–GC-related mortality, in elderly patients undergoing curative gastrectomy. This metric may support risk stratification and inform surgical strategies in this vulnerable population.</p>

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Association of Spirometric Lung Age with Survival Outcomes in Elderly Patients Undergoing Radical Surgery for Gastric Cancer

  • 期刊论文

  • 发表日期：

    2025年11月21日

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  • Masayuki Urabe,
  • Mami Suzuki,
  • Takahiro Fukai,
  • Yui Hasegawa,
  • Emi Terai,
  • Yoshitaka Kiya,
  • Goki Morizono,
  • Masaya Hiyoshi,
  • Toshiyuki Watanabe,
  • Yojiro Hashiguchi

摘要

Background

The proportion of elderly patients among those diagnosed with gastric cancer (GC) is increasing worldwide. Given that physiological reserves are often diminished in this population, reliable tools for preoperative risk stratification are essential to inform therapeutic decision-making. Lung age, a spirometry-derived clinical parameter, has been associated with postoperative outcomes in some malignancies; however, its relevance in GC remains unclear. This study retrospectively evaluated the prognostic significance of lung age in elderly GC patients undergoing curative gastrectomy.

Methods

A total of 155 GC patients aged ≥ 70 years who underwent R0 gastrectomy were analyzed. The age gap (AG), defined as the difference between lung age and chronological age, was examined in relation to clinicopathological characteristics, postoperative complications, and survival outcomes.

Results

AG was significantly associated with postoperative complications. In univariate analyses, AG showed significant associations with overall survival (OS) and non–GC-related mortality, but not with cancer-specific survival. In multivariate analysis, AG was not an independent predictor of OS; however, it remained an independent predictor of non–GC-related death, whether analyzed as a dichotomous variable (hazard ratio [HR] 3.14, 95% confidence interval [CI] 1.33–7.38, p = 0.009) or as a continuous variable (HR 1.25 per 10-year increase, 95% CI 1.01–1.54, p = 0.036).

Conclusion

The discrepancy between lung and chronological age may serve as a useful predictor of long-term outcomes, particularly non–GC-related mortality, in elderly patients undergoing curative gastrectomy. This metric may support risk stratification and inform surgical strategies in this vulnerable population.