Author/Editor		Ivanecz, Arpad; Jagrič, Tomaž; Hazabent, Marko; Gajzer, Borut; Horvat, Matjaž; Potrč, Stojan
Title		Ali starost bolnika vpliva na izid zdravljenja bolnikov z resektabilnim rakom želodca
Translated title		Does age influences the outcome of treatment in patients with resectable gastric cancer
Type		članek
Source		In: Potrč S, Hazabent M, Gajzer B, editors. 2. Mariborski onkološki dan: simpozij z mednarodno udeležbo na temo Maligna obolenja želodca; 2009 nov 27; Maribor. Maribor: Oddelek za abdominalno in splošno kirurgijo, Kirurška klinika UKC,
Publication year		2009
Volume		str. 224-38
Language		slo
Abstract		Objective: The relationship between prognosis and the age of patients with gastric carcinoma is controversial. The purpose of this study was to define the clinicopathological features and prognosis of gastric cancer in young European adults. Methods: Between January 1992 and December 2008, 772 patients with resected gastric cancer were enrolled in a prospective database. The findings for 58 (7.5%) patients aged 45 years or less were compared with those of 714 between the ages of 46 and 86. Results: We found significant differences in their ASA scores (p < 0.001): the majority of patients in the younger group scored ASA I (93%), while most of the patients in the older group scored ASA II or III (72%). In the younger group there were significantly more Lauren diffuse-type carcinomas (63% versus 36%; P = 0.007),total gastrectomies (79% versus 55%; P = 0.003), and harvested lymph nodes (26 19 versus 21 14; P = 0.02). There were no statistically significant differences in curative resections (86% versus 85%), TNM stage distribution, rate of perioperative surgical and non-surgical morbidity and mortality. Actuarial 5-year survival rates for the younger and the older groups were 43.8% and 34.1% respectively (P = 0.05). Actuarial 10-year survival rates for the younger and the older groups were 37% and 23.7% respectively (P = 0.05). The factors associated with adverse 5-year survival in multivariate analysis were higher TNM UICC stage, non-curative resection, higher ASA scores, and N2 - 3 lymph node metastases. Conclusions: Differences in the ASA scores between the two groups were expected. A second feature was the predominance of the Lauren diffuse type in the younger group. A higher portion of total gastrectomies and harvested lymph nodes were the consequences of the more aggressive surgical approach to the younger patients. (Abs. trunc. at 2000 ch.)
Summary		Izhodišča: Vpliv starosti na prognozo bolnikov z rakom želodca je predmet razprav. Namen prispevka je predstaviti značilnosti ter prikazati izid zdravljenja pri mlajših bolnikih z rakom želodca. Bolniki in metode: V obdobju od januarja leta 1992 do decembra 2008 smo pri 772 bolnikih opravili resekcijo želodca zaradi raka. Značilnosti 58 (7,5%) bolnikov, starih 45 let ali manj smo primerjali z značilnostmi 714 bolnikov, starih od 46 do 86 let. Rezultati: Značilne razlike smo ugotavljali pri porazdelitvi ASA statusa (p = 0,001), večina mlajših bolnikov je spadala v skupino ASA I (93%), medtem ko je bila večina starejših bolnikov porazdeljena v skupini ASA II ali III (72%). V skupini mlajših bolnikov je bilo značilno več difuznega tipa raka po Laurenu (63% proti 36%; P = 0,007), totalnih gastrektomij (79% proti 55%; P = 0,003) in odstranjenih bezgavk (26 19 proti 21 14; P = 0.02). Ni bilo statistično značilnih razlik med deležem R0 resekcij (86 proti 85%), porazdelitvi TNM stadijev ter med perioperativno obolevnostjo in smrtnostjo. Skupno 5-letno preživetje mlajše skupine bolnikov je bilo 43,8%, starejše skupine pa 34,1% (P = 0,05). Skupno 10-letno preživetje mlajše skupine bolnikov je bilo 37%, starejše skupine pa 23,7% (P = 0,05). Dejavniki, ki so bili v multivariatni povezani s vplivom na slabše preživetje so bili višji TNM UICC stadij, R1 ali R2 resekcija, višja ASA skupina ter zasevki v bezgavke N2 - 3. Zaključki: Razlike v porazdelitvi splošne sposobnosti izražene po klasifikaciji splošnega stanja po ASA so bile pričakovane. V mlajši skupini je prevladoval difuzni tip raka po Laurenu. Višji delež totalnih gastrektomij ter odstranjenih bezgavk je lahko posledica bolj agresivnega kirurškega pristopa pri mlajših bolnikih. Preživetje je bilo boljše pri mlajši skupini bolnikov, čeprav je izid zdravljenja verjetno bolj povezan s stadijem obolenja ob postavitvi diagnoze, kot pa s starostjo.
Descriptors		STOMACH NEOPLASMS TREATMENT OUTCOME PROGNOSIS