Total gastrectomy for patients over the age of 70 with gastric cancer

We analyzed data on 621 Japanese patients with gastric cancer treated with total gastrectomy, with respect to age of the patient. There were 123 patients aged 70 years and older. The mortality rate was 1.6% for the elderly patients and 1.4% for the others. In patients over the age of 70, there were fewer women and the differentiated tissue type was more common. The infiltrative Borrmann types 3 and 4 accounted for 53.6% of the elderly patients, serosal invasion was less prominent and the rate of peritoneal dissemination was lower. Extensive lymph node dissection (R2 or R3) was done for 65.9% of the elderly patients and the rate of curative resection was higher. There was no difference in survival rates among these patients. Liver metastasis, operative curability, serosal invasion, lymph node metastasis, tumor size and extensive lymph node dissection, but not age, proved to be independent prognostic factors for total gastrectomy, as determined by multivariate analysis. Thus, the outcome of surgery is good and the mortality rate is low in the elderly patients with gastric cancer undergoing total gastrectomy with lymphadenectomy and resection of adjacent organs. When considering the indications for total gastrectomy, the age of the patient should not be an untoward factor.