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The impact of age on long-term survival following gastrectomy for gastric cancer

Lookup NU author(s): Dr Anantha Madhavan, Shajahan Wahed, Dr Maziar Navidi, Nick Hayes, Professor Alexander PhillipsORCiD


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INTRODUCTION: Gastrectomy remains the primary curative treatment modality for patients with gastric cancer. Concerns exist about offering surgery with a high associated morbidity and mortality to elderly patients. The study aimed to evaluate the long-term survival of patients with gastric cancer who underwent gastrectomy comparing patients aged <70 years with patients aged ≥70 years. METHODS: Consecutive patients who underwent gastrectomy for adenocarcinoma with curative intent between January 2000 and December 2017 at a single centre were included. Patients were stratified by age with a cut-off of 70 years used to create two cohorts. Log rank test was used to compare overall survival and Cox multivariable regression used to identify predictors of long-term survival. RESULTS: During the study period, 959 patients underwent gastrectomy, 520 of whom (54%) were aged ≥70 years. Those aged <70 years had significantly lower American Society of Anesthesiologists grades (p<0.001) and were more likely to receive neoadjuvant chemotherapy (39% vs 21%; p<0.001). Overall complication rate (p=0.001) and 30-day postoperative mortality (p=0.007) were lower in those aged <70 years. Long-term survival (median 54 vs 73 months; p<0.001) was also favourable in the younger cohort. Following adjustment for confounding variables, age ≥70 years remained a predictor of poorer long-term survival following gastrectomy (hazard ratio 1.35, 95% confidence interval 1.09, 1.67; p=0.006). CONCLUSIONS: Low postoperative mortality and good long-term survival were demonstrated for both age groups following gastrectomy. Age ≥70 years was, however, associated with poorer outcomes. This should be regarded as important factor when counselling patients regarding treatment options.

Publication metadata

Author(s): Brown LR, Kamarajah SK, Madhavan A, Wahed S, Navidi M, Immanuel A, Hayes N, Phillips AW

Publication type: Article

Publication status: Published

Journal: Annals of the Royal College of Surgeons of England

Year: 2023

Volume: 105

Issue: 3

Pages: 269-277

Print publication date: 01/03/2023

Online publication date: 21/04/2022

Acceptance date: 08/12/2021

ISSN (print): 0035-8843

ISSN (electronic): 1478-7083

Publisher: Royal College of Surgeons of England


DOI: 10.1308/rcsann.2021.0355

PubMed id: 35446718


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