A comprehensive study on non-cancer-related mortality risk factors in elderly gastric cancer patients post-curative surgery

BMC Gastroenterol. 2024 Feb 19;24(1):78. doi: 10.1186/s12876-024-03170-6.

Abstract

Background: The increasing incidence of gastric cancer in the elderly underscores the need for an in-depth understanding of the challenges and risks associated with surgical interventions in this demographic. This study aims to investigate the risk factors and prognostic indicators for non-cancer-related mortality following curative surgery in elderly gastric cancer patients.

Methods: This retrospective analysis examined 684 patients with pathological Stage I-III gastric cancer who underwent curative resection between January 2012 and December 2021. The study focused on patients aged 70 years and above, evaluating various clinical and pathological variables. Univariate analysis was utilized to identify potential risk factors with to non-cancer-related mortality and to access prognostic outcomes.

Results: Out of the initial 684 patients, 244 elderly patients were included in the analysis, with 33 succumbing to non-cancer-related causes. Univariate analysis identified advanced age (≥ 80 years), low body mass index (BMI) (< 18.5), high Charlson Comorbidity Index (CCI), and the presence of overall surgical complications as significant potential risk factors for non-cancer related mortality. These factors also correlated with poorer overall survival and prognosis. The most common cause of non-cancer-related deaths were respiratory issues and heart failure.

Conclusion: In elderly gastric cancer patients, managing advanced age, low BMI, high CCI, and minimizing postoperative complications are essential for reducing non-cancer-related mortality following curative surgery.

Keywords: Elderly patients; Gastric cancer; Non-cancer related death.

MeSH terms

  • Aged
  • Gastrectomy / adverse effects
  • Humans
  • Mortality
  • Postoperative Complications / epidemiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms* / pathology