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Background <p>As the population of Japan continues to age rapidly, an increasing number of patients aged ≥ 80 years are undergoing surgery for gastric cancer. Although minimally invasive techniques have improved surgical safety, operative risks in the super-elderly population (≥ 85 years) remain a significant concern.</p> Methods <p>This retrospective, single-center study analyzed 72 patients aged ≥ 80 years who underwent gastrectomy for gastric cancer at our hospital between January 2014 and August 2024. Patients were stratified into two groups: the super-elderly group (≥ 85 years, <i>n</i> = 26) and the younger-elderly group (80–84 years, <i>n</i> = 46). Clinical characteristics, perioperative outcomes, and postoperative complications were compared between the two groups. A p-value of &lt; 0.05 was considered statistically significant.</p> Results <p>The mean age was 83.7 (range: 80–93) years. Comorbidities were common, particularly cardiovascular disease (19.4%) and diabetes mellitus (27.8%). Compared with the younger-elderly group, the super-elderly group had a longer preoperative hospital stay (5.8 vs. 4.5 days) but a shorter overall hospital stay (14.3 vs. 21.1 days). Minimally invasive surgery was less frequently performed in the super-elderly group (42.3% vs. 56.5%). Postoperative complications of Clavien–Dindo grade ≥ 2 occurred in 40.3% of all patients, with a lower incidence in the super-elderly group (34.6% vs. 43.5%). Mortality from non-cancer-related causes did not differ significantly between the groups.</p> Conclusions <p>With appropriate preoperative optimization, gastrectomy can be performed safely in patients aged ≥ 85 years. Individualized treatment strategies that account for comorbidities are essential for achieving favorable outcomes in this expanding population.</p>

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Outcomes of gastrectomy in octogenarians and nonagenarians: a comparative analysis in the era of minimally invasive surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月3日

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  • Kenjiro Ishii,
  • Yusuke Akimoto,
  • Osahiko Hagiwara,
  • Toshiyuki Enomoto,
  • Takaharu Kiribayashi,
  • Koji Asai,
  • Takuya Nagata,
  • Manabu Watanabe,
  • Yoshihisa Saida

摘要

Background

As the population of Japan continues to age rapidly, an increasing number of patients aged ≥ 80 years are undergoing surgery for gastric cancer. Although minimally invasive techniques have improved surgical safety, operative risks in the super-elderly population (≥ 85 years) remain a significant concern.

Methods

This retrospective, single-center study analyzed 72 patients aged ≥ 80 years who underwent gastrectomy for gastric cancer at our hospital between January 2014 and August 2024. Patients were stratified into two groups: the super-elderly group (≥ 85 years, n = 26) and the younger-elderly group (80–84 years, n = 46). Clinical characteristics, perioperative outcomes, and postoperative complications were compared between the two groups. A p-value of < 0.05 was considered statistically significant.

Results

The mean age was 83.7 (range: 80–93) years. Comorbidities were common, particularly cardiovascular disease (19.4%) and diabetes mellitus (27.8%). Compared with the younger-elderly group, the super-elderly group had a longer preoperative hospital stay (5.8 vs. 4.5 days) but a shorter overall hospital stay (14.3 vs. 21.1 days). Minimally invasive surgery was less frequently performed in the super-elderly group (42.3% vs. 56.5%). Postoperative complications of Clavien–Dindo grade ≥ 2 occurred in 40.3% of all patients, with a lower incidence in the super-elderly group (34.6% vs. 43.5%). Mortality from non-cancer-related causes did not differ significantly between the groups.

Conclusions

With appropriate preoperative optimization, gastrectomy can be performed safely in patients aged ≥ 85 years. Individualized treatment strategies that account for comorbidities are essential for achieving favorable outcomes in this expanding population.