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Volume 10 Supplement 1

de Senectute: Age and Health Forum

Patterns of neoplastic recurrence in gastrectomized elderly patients


The incidence of gastric cancer in elderly patients is increasing and the choice of treatment is controversial among physicians, oncologists and surgeons. In addition, about 2/3 of patients present a neoplastic recurrence after a curative intervention [1]. The aim of this study is the analysis of the factors which influence the risk of recurrence in elderly patients.

Materials and methods

All patients who received a gastrectomy for adenocarcinoma in our surgical department from January 1998 to December 2002 were admitted to the study. Inclusion criteria were: a) Curative resection (R0); b)no metastases before surgery; c)no other primitive neoplasms; d)consensus of the patient for a follow-up of 5 years. Recurrence was indicated as haematogenous, peritoneal or locoregional on the basis of the first site of metastases. Patients were divided into two groups by age: cut-off was considered 70 years old.


48 patients were admitted to the study : 26 male and 22 female patients, with a average age of 61,9 years old (37 – 80). 16 patients were ≥ 70 years old.

During a 5-year follow-up we observed in the older group 9 recurrences (56%) : in 44% cases there was a peritoneal recurrence, in 33% a haematogenous recurrence and in 23% of patients a locoregional disease. In patients < 70 years old we observed a peritoneal recurrence only in 5 % of cases. (Table 1).

Table 1 Recurrence site for age

Factors correlated with a neoplastic recurrence in the older group were: pTNM III at diagnosis (78% vs 43%), subtotal gastrectomy (65% vs 56%), Lauren diffuse adenocarcinoma (45% vs 33%) and a Linfonodal ratio (LNR) ≥ 20 % (89% vs 30%).(Table 2)

Table 2 Factors associated with recurrence in patients ≥ 70 years


In elderly patients we observed a neoplastic recurrence in 56% of cases: first site of disease was peritoneum (44% ) then haematogenous recurrence (33%).In younger patients, instead, a locoregional recurrence was more frequent (62% vs 23%). Predictive factors of neoplastic recurrence in elderly patients were: pTNM III, subtotal gastrectomy, Lauren diffuse adenocarcinoma and a LNR ≥ 20 %. These factors can help the surgeon and the oncologist to identify, in a population of elderly gastrectomized patients, who needs a closer follow-up due to a higher risk of recurrence, in order to permit a more aggressive therapy.


  1. Whiting J, Sano T, Saka M, Fukagawa T, Katai H, Sasako M: Follow-up of gastric cancer: a review. Gastric Cancer. 2006, 9: 74-81. 10.1007/s10120-006-0360-0.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Guida, F., Antonino, A., Coppola Bottazzi, E. et al. Patterns of neoplastic recurrence in gastrectomized elderly patients. BMC Geriatr 10 (Suppl 1), A10 (2010).

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