Browse > Article
http://dx.doi.org/10.5230/jgc.2016.16.1.43

Low Serum Albumin Level, Male Sex, and Total Gastrectomy Are Risk Factors of Severe Postoperative Complications in Elderly Gastric Cancer Patients  

Kang, Sung Chan (Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Kim, Hyun Il (Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Kim, Min Gyu (Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine)
Publication Information
Journal of Gastric Cancer / v.16, no.1, 2016 , pp. 43-50 More about this Journal
Abstract
Purpose: It is well known that old age is a risk factor for postoperative complications. Therefore, this study aimed to explore the risk factors for poor postoperative surgical outcomes in elderly gastric cancer patients. Materials and Methods: Between January 2006 and December 2015, 247 elderly gastric cancer patients who underwent curative gastrectomy were reviewed. In this study, an elderly patient was defined as a patient aged ${\geq}65$ years. All possible variables were used to explore the risk factors for poor early surgical outcomes in elderly gastric cancer patients. Results: Based on multivariate analyses of preoperative risk factors, preoperative low serum albumin level (<3.5 g/dl) and male sex showed statistical significance in predicting severe postoperative complications. Additionally, in an analysis of surgery-related risk factors, total gastrectomy was a risk factor for severe postoperative complications. Conclusions: Our study findings suggest that low serum albumin level, male sex, and total gastrectomy could be risk factors of severe postoperative complications in elderly gastric cancer patients. Therefore, surgeons should work carefully in cases of elderly gastric cancer patients with low preoperative serum albumin level and male sex. We believe that efforts should be made to avoid total gastrectomy in elderly gastric cancer patients.
Keywords
Stomach neoplasms; Aged; Risk factors; Postoperative complications;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 McKenna RJ Sr. Clinical aspects of cancer in the elderly. Treatment decisions, treatment choices, and follow-up. Cancer 1994;74(7 Suppl):2107-2117.   DOI
2 Wu CW, Lo SS, Shen KH, Hsieh MC, Lui WY, P'Eng F K. Surgical mortality, survival, and quality of life after resection for gastric cancer in the elderly. World J Surg 2000;24:465-472.   DOI
3 Kim MG, Kim HS, Kim BS, Kwon SJ. The impact of old age on surgical outcomes of totally laparoscopic gastrectomy for gastric cancer. Surg Endosc 2013;27:3990-3997.   DOI
4 World Health Organization (WHO). World health statistics 2014 [Internet]. Geneva: WHO; 2014 [cited 2014 May]. Available from: http://www.who.int/gho/publications/world_health_statistics/2014/en/.
5 Yancik R, Ries LA. Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am 2000;14:17-23.   DOI
6 Balducci L, Extermann M. Management of cancer in the older person: a practical approach. Oncologist 2000;5:224-237.   DOI
7 Feng MA, McMillan DT, Crowell K, Muss H, Nielsen ME, Smith AB. Geriatric assessment in surgical oncology: a systematic review. J Surg Res 2015;193:265-272.   DOI
8 Polanczyk CA, Marcantonio E, Goldman L, Rohde LE, Orav J, Mangione CM, et al. Impact of age on perioperative complications and length of stay in patients undergoing noncardiac surgery. Ann Intern Med 2001;134:637-643.   DOI
9 Evers BM, Townsend CM, Jr, Thompson JC. Organ physiology of aging. Surg Clin North Am 1994;74:23-39.   DOI
10 Salive ME. Multimorbidity in older adults. Epidemiol Rev 2013;35:75-83.   DOI
11 From the centers for disease control and prevention. Public health and aging: trends in aging: United States and worldwide. JAMA 2003;289:1371-1373.   DOI
12 Kim KI, Park KH, Koo KH, Han HS, Kim CH. Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery. Arch Gerontol Geriatr 2013;56:507-512.   DOI
13 Lipska MA, Bissett IP, Parry BR, Merrie AE. Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg 2006;76:579-585.   DOI
14 Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999;134:36-42.   DOI
15 Moghadamyeghaneh Z, Hwang G, Hanna MH, Phelan MJ, Carmichael JC, Mills SD, et al. Even modest hypoalbuminemia affects outcomes of colorectal surgery patients. Am J Surg 2015;210:276-284.   DOI
16 Kirchhoff P, Dincler S, Buchmann P. A multivariate analysis of potential risk factors for intra- and postoperative complications in 1316 elective laparoscopic colorectal procedures. Ann Surg 2008;248:259-265.   DOI
17 Sasako M. Risk factors for surgical treatment in the Dutch Gastric Cancer Trial. Br J Surg 1997;84:1567-1571.   DOI
18 Launois B, Cardin JL, Bardaxoglou E, Bourdonnec P, de Chateaubriant P, Buard JL, et al. Management of cancer of the stomach: total gastrectomy versus sub-total gastrectomy. Hepatogastroenterology 1991;38:45-52.
19 Korenaga D, Moriguchi S, Baba H, Kakeji Y, Orita H, Haraguchi M, et al. Surgery for gastric carcinoma is feasible for patients over 80 years of age. World J Surg 1991;15:642-647; discussion 647-648.   DOI
20 Seo SH, Hur H, An CW, Yi X, Kim JY, Han SU, et al. Operative risk factors in gastric cancer surgery for elderly patients. J Gastric Cancer 2011;11:116-121.   DOI
21 Otsuji E, Fujiyama J, Takagi T, Ito T, Kuriu Y, Toma A, et al. Results of total gastrectomy with extended lymphadenectomy for gastric cancer in elderly patients. J Surg Oncol 2005;91:232-236.   DOI
22 Kitamura K, Yamaguchi T, Taniguchi H, Hagiwara A, Yamane T, Sawai K, et al. Clinicopathological characteristics of gastric cancer in the elderly. Br J Cancer 1996;73:798-802.   DOI
23 Gretschel S, Estevez-Schwarz L, Hunerbein M, Schneider U, Schlag PM. Gastric cancer surgery in elderly patients. World J Surg 2006;30:1468-1474.   DOI
24 Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono HA, et al. Comparison of surgical outcomes of gastric cancer in elderly and middle-aged patients. Am J Surg 2006;191:216-224.   DOI
25 Mohri Y, Yasuda H, Ohi M, Tanaka K, Saigusa S, Okigami M. Short- and long-term outcomes of laparoscopic gastrectomy in elderly patients with gastric cancer. Surg Endosc 2015;29:1627-1635.   DOI
26 Kunisaki C, Makino H, Takagawa R, Oshima T, Nagano Y, Ono HA, et al. Efficacy of laparoscopy-assisted distal gastrectomy for gastric cancer in the elderly 2009;23:377-383.   DOI
27 Statistics Korea. Korean Statistical Information Service [Internet]. Daejeon: Statistics Korea; [cited 2011 May 1]. Available from: http://kosis.kr/.
28 Popovic JR. 1999 National hospital discharge survey: annual summary with detailed diagnosis and procedure data. Vital Health Stat 2001:1-206.
29 Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol 2010;17:3077-3079.   DOI
30 Jiang N, Deng JY, Ding XW, Ke B, Liu N, Zhang RP, et al. Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer. World J Gastroenterol 2014;20:10537-10544.   DOI
31 Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai Zasshi 1984;85:1001-1005.
32 Strasberg SM, Linehan DC, Hawkins WG. The accordion severity grading system of surgical complications. Ann Surg 2009;250:177-186.   DOI
33 Kothari A, Phillips S, Bretl T, Block K, Weigel T. Components of geriatric assessments predict thoracic surgery outcomes. J Surg Res 2011;166:5-13.   DOI
34 Puts MT, Hardt J, Monette J, Girre V, Springall E, Alibhai SM. Use of geriatric assessment for older adults in the oncology setting: a systematic review. J Natl Cancer Inst 2012;104:1133-1163.
35 Hamaker ME, Jonker JM, de Rooij SE, Vos AG, Smorenburg CH, van Munster BC. Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review. Lancet Oncol 2012;13:e437-e444.   DOI