Prognostic impact of postoperative complications among elderly patients with gastric cancer
- 1Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- 2Department of Medical Statistics, Osaka Metropolitan University Graduate school of Medicine, Osaka, Japan
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.
Related
- Postoperative hypoalbuminemia, albumin supplementation, and short-term complications after radical gastrectomy in elderly gastric cancer patients
- Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial
- Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.
- Effects of isobaric spinal anesthesia combined with different nerve block techniques on postoperative pain and complications in elderly patients undergoing proximal femoral nail antirotation: a retrospective observational study
- Impact of Elderly Donors on Patient Survival and Postoperative Complications in Liver Transplantation: A Retrospective Study
BibTeX
@article{matsuoka2026prognostic,
title = {{Prognostic impact of postoperative complications among elderly patients with gastric cancer}},
author = {Kohei Matsuoka and Yuichiro Miki and Ryota Kawai and Masaki Nishiyama and Yuki Seki and Kenji Kuroda and Hiroaki Kasashima and Mami Yoshii and Tatsuro Tamura and Masatsune Shibutani and Takahiro Toyokawa and Ayumi Shintani and Kiyoshi Maeda},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0359100},
url = {https://doi.org/10.1371/journal.pone.0359100},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prognostic impact of postoperative complications among elderly patients with gastric cancer
AU - Kohei Matsuoka
AU - Yuichiro Miki
AU - Ryota Kawai
AU - Masaki Nishiyama
AU - Yuki Seki
AU - Kenji Kuroda
AU - Hiroaki Kasashima
AU - Mami Yoshii
AU - Tatsuro Tamura
AU - Masatsune Shibutani
AU - Takahiro Toyokawa
AU - Ayumi Shintani
AU - Kiyoshi Maeda
PY - 2026
DA - 2026/09/29
JO - PLOS One
DO - 10.1371/journal.pone.0359100
UR - https://doi.org/10.1371/journal.pone.0359100
AB - 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.
SN - 1932-6203
ER -