Background: In the western countries the population is rapidly aging resulting in an increasing number of elderly patients. In parallel, the incidence of gastric cancer in people over 65 years of age has increased remarkably. The optimal treatment for these patients remains a challenge to the surgeon. The aim of this retrospective analysis was to compare the results of curative resections for gastric cancer in patients with different age. Methods: We performed a retrospective analysis of 182 patients who underwent total or partial gastrectomy with extended D2-lymphadenectomy for gastric carcinoma between 2000 and 2004. Postoperative complication rates (30-day morbidity) were compared between patients in three age groups (<45y.: n=24, 45-65y.: n=74, >65y.: n=84). Chi-square tests were performed for statistical analyses. Results: Advanced tumor growth (T-stage) was significant more frequent in younger patients (p<0.001), where nodal involvement (N-stage) was not statistical different. Major surgical complications occurred in 12% of all patients and minor complications were documented in additional 9%. The 30-day morbidity was significantly higher in young patients (p<0.05). The most important course for major complications were anastomotic leckages. Discussion: The operative outcome of gastric cancer patients over 65 years of age was comparable to that of younger patients after curative resections with extensive lymphadenectomy. The increased 30-day morbidity in patients with an age <45 years can be explained by more advanced local tumors in this group.
Morbidity after curative resections