Cancer of the Stomach
Gastric cancer is considered one of the most frequent neoplasm of the old age with a peak in the seventh decade of life. Even if the overall incidence of gastric cancer has been reduced during the last decades, it is expected an increase number of new cases among old patients because of the elderly population is on rise. The clinicopathological features of gastric cancer in elderly patients are different from those of non-elderly patients: male predominance, localization in the lower third of the stomach, more histological differentiation, advanced TNM stage at the diagnosis. In elderly, as for young patients, surgical resection remains the only curative treatment. Preoperative comorbidities and the high risk of postoperative complications influence the surgical approach. For early gastric cancer, endoscopic resection is performed when there is no evidence of lymph node metastasis. For advanced cases, if feasible, performing a subtotal gastrectomy with limited lymphadenectomy offers a better quality of life and lower mortality rather than total gastrectomy associated to extended nodes dissection, with no significant difference in overall survival. After surgery, adjuvant chemotherapy should be determined by considering the conditions of individual patients and their life expectancies.
KeywordsElderly Gastric cancer Age Gastrectomy Lymphadenectomy Comorbidity Stomach
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