Gastric cancer: What is the optimal surgical strategy in the elderly?

Key clinical point: In older patients with potentially resectable gastric cancer, gastrectomy vs. conservative treatment may improve survival. The minimally invasive approach has fewer complications and extended lymphadenectomy may have survival benefit.

Major finding: Gastrectomy vs. conservative treatment improved overall survival in all six studies included in the analysis, but study quality was low and meta-analysis was not feasible. Minimally invasive vs. open gastrectomy was associated with fewer complications (pooled risk ratio 0.71; P = .005) and similar OS (P = .58). Extended vs. limited lymphadenectomy prolonged OS or cancer-specific survival in two cohort studies, with similar complication rates.

Study details: This systematic review of 31 studies included patients aged ≥ 70 years with potentially resectable stage I-III gastric cancer.

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Disclosures: This study had no sponsors. The authors declared no conflicts of interest.

Source: Argillander TE et al. Outcomes of surgical treatment of non-metastatic gastric cancer in patients aged 70 and older: A systematic review and meta-analysis. Eur J Surg Oncol. 2022 (May 16). Doi: 10.1016/j.ejso.2022.05.003