BACKGROUND/AIMS 

The aim of this study is to evaluate whether super-elderly patients (>=80) with gastric cancer may be appropriate candidates for an R2/R3 (extended) gastrectomy.

METHODOLOGY 

The study evaluated 1334 patients with gastric cancer treated over the past 15 years, who were over 40 years of age.

They were divided into three groups according to age : Super-elderly patients who were over 80 (group A ; n=60), those aged 60-79 (group B ; n=703) and those aged 40-59 (group C ; n=571).

RESULTS 

The incidence of concomitant systemic disorders was higher in group A than in either group B or group C (65% vs. 53.2% vs. 34%) (p<0.0001).

The resection rates were similar (88.3% vs. 93.7% vs. 96.1%), however, the incidence of a total gastrectomy, an R2/R3 dissection, or a combined resection of other organs was much lower in group A than those in the other groups (p<0.005).

The survival curves of patients after a curative resection were not significant, however, 34.4% of the super-elderly patients died of other causes and the 5-year survival rates including other cause of death were poorer in groups A and B than those in group C (p<0.01).

In group A, patients receiving an R2/R3 dissection had a two-fold higher incidence of post-operative complications over those receiving an R0/R1 (regional) dissection, however, they also had a better prognosis whether or not other causes of death were considered. (...)