- Surgical treatment of gastric cancer in elderly patients

Gastric adenocarcinoma is considered a disease of the elderly, with a peak incidence in the seventh and eight decades of life. in the elderly biochemical changes in tissue and in organ physiology in association with HP infection, lead to atrphic gastritis, with an increased risk of developing cancer. gastric cancer in the elderly is often diagnosed at an advanced stage and is associated with a poor prognosis in terms of disease free and overall survival. surgical treatment of gastric cancer in these patients remains controersial due to the increased perioperative risk; instead subtotal gastrectomy is preferred when feasible. total resections with or without combined resections of adjacent organs is associated with higher rates of postoperative morbidity and mortality. for advanced cancers palliative resection is prefereable, whenever possible, to gastroenterostomy. morbidity and mortality are higher in the elderly, probably related to the comorbidities in these patients. T stage,, limph node metastates, and depth of invasion of the primary tumor are recognized as indipendent prognostic factors in terms of overall survival. the impact of multimodality treatment in the ederly cannot be clearly evaluated; currently adjuvant chemotherapy is recommended in otherwise healthy patients. in general age alone has not been definitively confirmed as a negative prognostic factor in patients with gastric cancer and should not preclude gastrica resection. after radical resection, elderly patients have the same chance of survival as middle-age patients.