RESUMEN
BACKGROUND/AIMS: It has been known that elderly patients with gastric cancer show worse general condition and higher comorbidities. Therefore, few elderly patients undergo surgery. This study was designed to determine clinicopathological characteristics of gastric cancer in elderly patients and evaluate their survival improvements by the surgical treatment. METHODS: Gastric cancer patients, diagnosed at Ewha Womans University Mokdong Hospital between 2000 to 2004, were divided into two groups those aged ≥65 years vs. <65 years. Clinicopathological characteristics, incidence of postoperative complications, and survival time of patients in each group were analyzed. RESULTS: Total 370 patients were subjected and divided into the elderly and the younger group (55.4% vs. 44.6%). The elderly group showed higher incidences of hypertension and cardiovascular disease. Well differentiated adenocarcinoma was more frequently found in the elderly group (19.0% vs. 10.0%, p=0.025). There were no differences of operation time (242.6±70.7 vs. 257.3±83.8 min, p=0.115), postoperative hospital stays (15.8±10.6 vs. 14.7±9.8 days, p=0.361), and incidence of any complications (6.7% vs. 9.9%, p=0.309) between the two subgroups. The significant factors related with the elderly patient's survival were the tumor-node-metastasis (TNM) stage (stage I, hazard ratio [HR] 1.00; stage II, HR 1.28, 95% confidence interval [CI] 0.44-3.72; stage III, HR 4.06, 95% CI 2.08-7.92, stage IV, HR 9.78, 95% CI 4.97-19.26; p<0.001) and the treatment modality (laparoscopy, HR 1.00; open surgery, HR 3.90, 95% CI 2.43-6.26; p<0.001). The elderly patients who underwent gastric cancer surgery showed prolonged survival on TNM stage I, II, and III than those who were treated conservatively. CONCLUSIONS: In the elderly patients with gastric cancer, those who had received surgical treatments showed significantly higher survival rate than those who had treated conservatively. Therefore, aggressive surgical treatments should be seriously considered even for the elderly patients with gastric cancer.
Asunto(s)
Adenocarcinoma/patología , Envejecimiento , Neoplasias Gástricas/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adulto , Anciano de 80 o más Años , Antígeno Carcinoembrionario/análisis , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Estimación de Kaplan-Meier , Tiempo de Internación , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugíaRESUMEN
BACKGROUND/AIMS: Three dimensional (3-D) ultrasonography is definitely more accurate than conventional 2-D ultrasonography in volume measurement of intra-abdominal organs. However, its application in measuring gastric emptying time has been limited. Thus, we tried to measure gastric antral emptying time by using 3-D ultrasonography and compare with that by radio-scintigraphy. METHODS: We performed both 3-D ultrasonography and radio-scintigraphy on the same day in 23 healthy subjects. After overnight fast, the subjects ingested 500 mL of soup meal (84 Kcal) that had been pre-mixed with 1 mCi of technetium(99m). The half emptying time (T(1/2)) measured by 3-D ultrasonography was defined by the time when the gastric antral volume decreased to half. RESULTS: The mean T(1/2) of 23 healthy subjects measured by 3-D ultrasonography was 23.4 +/- 10.5 min, while that measured by scintigraphy was 28.4 +/- 14.4 min. The difference (p=0.11 by paired t-test) between the two methods was not significant. Moreover, no significant correlation of T1/2 between the two methods (r=0.361, p=0.09) was observed. CONCLUSIONS: Measuring gastric antral emptying time with 3-D ultrasonography may be useful but require further validation studies and advance in technology.