AI Article Synopsis
- The study examines the increasing trend of distal gastrectomy in elderly patients (≥80 years old) in Japan, highlighting that total gastrectomy is being avoided due to poorer outcomes.
- A review of medical records from patients who underwent either total or distal gastrectomy showed that those with total gastrectomy had a median survival time of 21.3 months, significantly lower compared to 74.1 months for distal gastrectomy patients.
- The findings suggest that total gastrectomy is associated with a higher risk of complications, specifically pneumonia, leading to worse survival rates in elderly patients.
Article Abstract
Purpose: In Japan, the number of distal gastrectomy for patients ≥ 80 years old is increasing, whereas that of total gastrectomy is decreasing. Surgeons seem to avoid total gastrectomy for elderly patients. Total gastrectomy is reported to have a poorer prognosis than distal gastrectomy, and postoperative pneumonia may be involved in the cause.
Methods: The medical records of 39 and 108 patients ≥ 80 years old who underwent total and distal gastrectomy, respectively, at 2 affiliated institutions between 2010 and 2019 were retrospectively reviewed. Prognoses were compared between the two groups, focusing on death from pneumonia.
Results: The median overall survival time after total and distal gastrectomy was 21.3 and 74.1 months, respectively, with a significantly poorer prognosis after total gastrectomy than after distal gastrectomy (p < 0.01, hazard ratio [HR] 2.20, 95% confidence interval [CI] 1.37-3.53). The gastric cancer-specific survival time was significantly worse after total gastrectomy than after distal gastrectomy (p < 0.01, HR 2.73, 95% CI 1.29-5.79). The pneumonia-specific survival time was also significantly worse after total gastrectomy than after distal gastrectomy (p = 0.01, HR 3.44, 95% CI 1.25-9.48).
Conclusions: Patients who underwent total gastrectomy had a poorer prognosis than those who underwent distal gastrectomy, because many patients died of pneumonia early after total gastrectomy.
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| http://dx.doi.org/10.1007/s00595-022-02599-0 | DOI Listing |
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