Gastric cancer in the elderly.

The surgical treatment of gastric cancer in the elderly (over 65 years of age) was retrospectively studied in the department of surgery, at the Mount Sinai Medical Center, Miami Beach, Florida. The authors found 22 patients who were operated on for gastric cancer between 1979 and 1982. Ages ranged from 69 to 90 years of age. The male-to-female ratio was 1:1. Twenty of 22 patients were found to have carcinoma. Eleven of 20 had regional spread to the perigastric nodes, transverse colon, omentum, spleen, and liver. Stage of disease was: stage I--four patients, stage II--five patients, stage III--eight patients, and stage IV--three patients. Two of 22 patients had lymphoma. The mean hospital stay was 17.1 days, but decreased to 12.4 days if no complications occurred. Postoperative complications were minimal and included pneumonia, urinary tract infection, wound infection, and dumping syndrome. There were two postoperative deaths (9%) due to sepsis and myocardial infarction, respectively. Six of the remaining 18 patients died within 1 year. Seven of 18 were alive after 2 years, and six patients survived greater than 36 months (33%). Of the six long-term survivors, two had stage III and one had stage IV disease at the initial exploration. The average survival was 23.5 months. The authors conclude that gastric resection should not be withheld in the elderly. The elderly have the same morbidity and mortality from surgery for gastric cancer as patients under age 65.(ABSTRACT TRUNCATED AT 250 WORDS)