Adjuvant Chemotherapy After Gastric Cancer Surgery Is Also Effective for Elderly Patients Over 75—Avoiding Postoperative Complications Remains a Challenge

A joint research group, including Yasuhide Yamada, Director of the Department of Research Medicine at the National Center for Global Health and Medicine; Hiroyuki Konno, President of Hamamatsu University School of Medicine; Hiroya Takeuchi, Professor in the Second Department of Surgery at Hamamatsu University School of Medicine; Yuko Kitagawa, Professor in the Department of Surgery (General and Gastroenterological) at Keio University School of Medicine; Yasuhiro Kodera, Hospital Director of Nagoya Medical Center; Yuichiro Doki, Professor in the Department of Gastroenterological Surgery at the Graduate School of Medical Sciences, Osaka University; Kazuhiro Yoshida, President of Gifu University; and Yoshihiro Kakeji, Professor of Surgery at Kobe University, analyzed data from the nationwide gastric cancer registry to identify the characteristics of patients with gastric cancer, particularly those over 75, and the factors affecting their survival time.

Longer survival times were observed in patients who were 75 years old or younger, female, asymptomatic before surgery, had normal preoperative renal function, did not undergo total gastrectomy, and underwent laparoscopic surgery.

Adjuvant chemotherapy after gastrectomy to prevent recurrence was found to be effective for elderly patients over 75 with stage II or III gastric cancer, just as it is for patients 75 and younger who are typically included in clinical trials.

Age over 75, renal dysfunction, having symptoms before surgery, and undergoing total gastrectomy were significant risk factors for postoperative complications. Furthermore, it was difficult to continue postoperative adjuvant chemotherapy due to reasons such as side effects.

The life-prolonging effect of adjuvant chemotherapy was also demonstrated for CY1 gastric cancer, where cancer cells had spread into the abdominal cavity at the time of surgery.