Gastric cancer in patients above 70 years of age

Clinical records of 406 patients over 70 years of age with gastric cancer operated on during the past 22 years were analyzed. These cases amounted to 11.8% of the 3,425 patients with gastric cancer treated surgically at our hospitals during the same period. The primary tumor was confined to the upper one‐third portion of the stomach in 15.8% of the cases, which was significantly higher than that usually reported. Macroscopic staging of the lesion revealed that more than two‐thirds of the patients were suffering from highly advanced disease. The size of the tumor was larger than 50 mm in diameter in 50.8% of the cases. The tumor was predominantly of Borrmann II and III types. Early gastric cancer was observed in only 14.8% of the cases, which was approximately one‐half of the usual rate. However, histological study revealed well‐differentiated adenocarcinoma in two‐thirds of the lesions, a remarkable characteristic of gastric cancer in the elderly. Resection was possible in 70.9%, and curative resection was performed in 46.8%. The over‐all hospital mortality rate was 16.5%. The prognosis of curative resection cases yielded a 5‐year survival rate of 51.5% and 10‐year survival rate of 25.5%. These results would justify the practice of early diagnosis and aggressive surgery in every acceptable risk patient, if no contraindication exists.