{
  "abstract": "Background: Japan’s rapidly aging population has led to an increase in elderly patients undergoing gastrectomy for gastric cancer. However, the impact of postoperative complications on survival in patients aged ≥80 years remains unclear. This study aimed to evaluate the association between postoperative complications and survival outcomes in patients aged ≥80 years with gastric cancer. Materials and methods: We retrospectively analyzed 61 patients aged ≥80 years who underwent gastrectomy with D2 lymph node dissection between 1999 and 2020. Postoperative complications were classified according to the Clavien-Dindo (CD) classification into a “no or minor complication group” (CD Grade ≤ II, including no postoperative complications) and a “major complication group” (CD Grade ≥ III), and the impact of postoperative complications on survival outcomes were assessed. A subgroup analysis excluding macroscopic type 4 was also performed. Results: Postoperative complications occurred in 24 patients (39.3%), of which 8 (13.1%) experienced major complications. Patients in the major complication group had a significantly longer postoperative hospital stay, while other baseline characteristics were similar between groups. Kaplan–Meier analysis showed a trend toward poorer OS in the major complication group (P = 0.063), and recurrence-free survival (RFS) was significantly worse in this group (P = 0.004). Multivariate analysis showed that postoperative complications of CD grade ≥ III were independently associated with poorer OS (HR 2.51; 95% CI 1.01–6.24; P = 0.049). Subgroup analysis in patients without type 4 also showed significantly worse OS in the major complication group (P = 0.036). Conclusion: This study showed that postoperative complications were associated with poorer OS and RFS even in patients aged ≥80 years with gastric cancer. Future large-scale studies are needed to further clarify this association and optimize treatment strategies for this population.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan",
    "Department of Medical Statistics, Osaka Metropolitan University Graduate school of Medicine, Osaka, Japan"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kohei Matsuoka"
    },
    {
      "affs": [
        1
      ],
      "name": "Yuichiro Miki"
    },
    {
      "name": "Ryota Kawai"
    },
    {
      "name": "Masaki Nishiyama"
    },
    {
      "name": "Yuki Seki"
    },
    {
      "name": "Kenji Kuroda"
    },
    {
      "name": "Hiroaki Kasashima"
    },
    {
      "name": "Mami Yoshii"
    },
    {
      "name": "Tatsuro Tamura"
    },
    {
      "name": "Masatsune Shibutani"
    },
    {
      "name": "Takahiro Toyokawa"
    },
    {
      "name": "Ayumi Shintani"
    },
    {
      "name": "Kiyoshi Maeda"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bqeet51papxm1.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0359100",
  "fulltext_url": null,
  "id": "bqeet51papxm1",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0359100",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Gastric Cancer Management and Outcomes"
    ],
    [
      "plos",
      "/Medicine and health sciences/Clinical medicine/Clinical oncology/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Geriatric care"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer treatment"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer treatment/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gastrointestinal tumors/Gastric cancer"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Clinical oncology/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmaceutics/Drug therapy/Chemotherapy/Cancer chemotherapy/Adjuvant chemotherapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Blood and lymphatic system procedures/Lymph node dissection"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Digestive system procedures"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Digestive system procedures/Gastrectomy"
    ]
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  "openalex": "W7214775722",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0359100&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-29",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/bqeet51papxm1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0359100",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0359100"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:oncology",
      "subfield": "oncology"
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    {
      "field": "medicine",
      "origin": "plos:surgical and invasive medical procedures",
      "subfield": "surgery"
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  ],
  "title": "Prognostic impact of postoperative complications among elderly patients with gastric cancer",
  "title_text": "Prognostic impact of postoperative complications among elderly patients with gastric cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/bqeet51papxm1",
  "venue": "PLOS One",
  "versions": []
}