Clinical Outcomes of Gastrectomy in Very Elderly Gastric Cancer Patients Over 90 Years of Age

We investigated the clinical outcomes of gastrectomy in 7 patients over 90 years of age. Four patients were male and 3 were female. The tumor was located in the U region in 1 patient, M region in 2, and L region in 4. Four patients had circumferential involvement, and 3 had obstruction of passage, 1 of which was caused by gastric perforation. The preoperative prognostic nutritional index(PNI)was low(<40)in 4 patients, and the clinical Stage was Ⅰ in 1 patient, ⅡB in 3, and Ⅲ in 3. The surgical approach was laparotomy in 4 patients and laparoscopy in 3, and the surgical procedure comprised distal gastrectomy in 6 patients and proximal gastrectomy in 1. Lymph node dissection was D1 in 2 patients, D1+in 2, and D2 in 3. Consequently, R0 resection was performed in 6 patients and R2 resection in 1. Postoperative complications were observed in 4 patients, all of whom were treated conservatively. The duration of postoperative hospital stay was 11(9-18)days, and 5 patients(71.4%)were discharged to their home. Postoperative chemotherapy was administered to only 1 patient who underwent R2 resection. The long-term outcomes were as follows: 1 patient died of gastric cancer and 2 died of other diseases. Although the postoperative complication rate is relatively high in very elderly patients over 90 years of age with poor nutritional status, gastrectomy can be performed relatively safely, considering the indications for surgery and adequate planning.