| Objective:By contrastive analysis of the clinicopathological characteristics of gastric cancer in middle-aged and elderly people,the similarities and differences of gastric cancer in middle-aged and elderly people were discussed,providing certain reference value for the clinical diagnosis and treatment of gastric cancer in elderly people.Method:From January 2014 to December 2018,282 middle-aged and elderly patients with gastric cancer over the age of 50 who were admitted to the department of gastrointestinal,colorectal and anal surgery of our hospital and met the inclusion and exclusion criteria were selected as the research objects.According to the age,123 cases were divided into the middle-aged group(50-69 years old),116 cases in the advanced age group(70-79 years old),and 43 cases in the advanced age group(80 years old or above).The middle-aged group,advanced age group,and advanced age group were respectively defined as group A,B,and C.The data of the number of patients,clinical manifestations,disease site,tumor size,clinical stage(TNM stage),histological credit type,surgical method,perioperative mortality,length of hospital stay,postoperative complications and so on were collected.SPSS22.0 software was used for statistical analysis,and 2 test,Fisher exact probability test and kruskal-wallis rank sum test were used for data differences.P<0.05 was statistically significant.Result:(1)The ratio of men to women in each group: the ratios of males and females in group A,group B and group C were: 2.3:1,2.5:1 and 1.7:1,respectively.All groups were dominated by males,which were 70%,72% and 63%,respectively.There was no significant difference in the incidence between groups between males and females(P values were >0.05).(2)Comparison of clinical manifestations between groups: non-specific symptoms,such as abdominal pain and abdominal distension,were predominant in group A,group B and group C,with 81%,91% and 60%,respectively.The incidence of abdominal pain and abdominal distension in group C was significantly lower than that in group A and B(P <0.05).Group C with 23% incidence of nausea,vomiting,significantly more than group A(7%)(P < 0.05),group B hematemesis,black on the symptom such as incidence was 14%,significantly more than group A(2%)(P < 0.05),group B the incidence of dysphagia was 1%,significantly less than group A(8%)(P < 0.05),between groups in physical examination abnormal rate is low,respectively for 7%,2%,5%.There was no significant difference between the groups(P<0.05).(3)Comparison of disease sites between each group: There was no significant difference in the location of the disease between the three groups(P>0.05),with the majority in the lower 1/3 of the stomach,and the incidence was 56%,60% and 72%,respectively.(4)Comparison of tumor size between groups: The proportion of tumors above 4cm in group A,B and C was 39%,60% and 60%,respectively.The proportion of tumors above 4cm in group B and C was significantly higher than that in group A(P<0.05),and there was no significant difference between group B and C(P>0.05).(5)Comparison of organizational credit types among groups: There was no significant difference in histological type between the groups(P>0.05).Low-differentiation and other types were the main types in group A,accounting for 54%,and highly and moderately differentiated adenocarcinoma accounted for 46%.High and moderately differentiated adenocarcinomas predominated in group B and group C(51% and 58%,respectively).(6)Clinical staging(TNM staging)was compared between the groups: stage IV tumors in group C(35%)were significantly more than those in group A(17%)and group B(15%)(P <0.05).(7)T staging between groups: T3/T4 staging was dominant in groups A,B and C,accounting for 71%,89% and 86%,respectively.There was no significant difference in T stage between the groups(P>0.05).(8)N staging between groups:Lymphatic metastasis was dominant in groups A,B and C,with lymph node metastasis rates of 50%,54% and 62%,respectively.There was no significant difference in lymph node metastasis rate between the groups(P>0.05).(9)Comparison of M stages between each group: the M1 stages of group A,B and C were 12%,9% and 26%,respectively.The distant metastasis rate of group C was significantly higher than that of group A and B(P <0.05).(10)Comparison of M staging among groups comparison of surgical methods among groups: Radical operations were performed in 92%,91% and 74% of the patients in each group.The radical operation rate of group C was significantly lower than that of group A and group B(P <0.05).(11)Postoperative complications were compared between each group: the incidence of postoperative complications(cardiopulmonary complications,anastomotic leakage,postoperative bleeding,and gastroparesis,etc.)in group A,B,and C was 14%,23%,and 46%,respectively.The incidence of postoperative complications in group C was significantly higher than that in group A and group B(all P <0.05).(12)Length of hospital stay between groups: Patients in groups A,B and C who were hospitalized for more than 20 days were 15%,33% and 49%,respectively.Patients in groups B and C who were hospitalized for more than 20 years were significantly more than those in group A(all P <0.05).(13)Comparison of perioperative mortality between groups: the perioperative mortality of group A,B and C was 2%,4% and 7%,respectively,and there was no significant difference in the perioperative mortality of each group(P>0.05).Conclusion:1.Elderly patients with gastric cancer have a high rate of radical surgery and less postoperative complications.Therefore,radical surgery should be actively performed for elderly patients with gastric cancer.2.Elderly patients with gastric cancer have insidious onset,large tumor size,late TNM stage,high rate of distant metastasis,low rate of radical surgery,more postoperative complications and long hospital stay. |
