Merve YUMAK, Abdulkadir DENİZ
Anatolian Current Medical Journal - 2026;8(1):134-138
Aims: Gastric cancer remains one of the leading causes of cancer-related deaths worldwide. A significant proportion of patients are elderly, a group with unique challenges including higher comorbidity burden and reduced treatment tolerance, making the identification of prognostic determinants essential for personalized care. To evaluate clinicopathological factors associated with mortality and recurrence in gastric cancer patients aged 65 years and older undergoing gastrectomy at a tertiary referral center. Methods: This retrospective cohort study included 65 patients aged >=65 years who underwent total or subtotal gastrectomy at a tertiary care center. Demographic, surgical, pathological, and treatment data were analyzed. Associations with mortality and recurrence were assessed using Chi-square and Mann-Whitney U tests, with statistical significance defined as p<0.05. Results: Among 65 included patients (mean age 73.5+/-5.9 years; 73.8% female), the cardia was the most common tumor location (52.3%). Overall mortality and recurrence rates were 80.0% and 69.2%, respectively. Mortality was significantly associated with advanced age (74.9+/-5.5 vs. 67.8+/-3.9 years, p<0.001), cardia tumor localization (57.7% vs. 30.7%, p=0.003), and N3 lymph node involvement (46.2% vs. 7.7%, p=0.014). Recurrence was significantly higher among patients not receiving adjuvant therapy (75% vs. 40%, p=0.009) and among female patients (82.2% vs. 55%, p=0.021). Conclusion: In elderly gastric cancer patients, advanced age, proximal tumor location, and extensive nodal disease predict higher mortality, while omission of adjuvant therapy and female gender are associated with increased recurrence risk. These findings highlight the need for individualized treatment strategies and optimized surveillance in this population.
