J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 757KB） [Members Only]

J.Jpn. Surg. Soc.. 118(3): 325-331, 2017

Special contribution

A QUESTIONNAIRE SURVEY ABOUT EVALUATION OF OPERATIVE RISK AND DECISION MAKING ON TREATMENT STRATEGIES IN THE ELDERLY WITH GASTROINTESTINAL CANCER

1) Department of Surgery, Kyoto City Hospital, Kyoto, Japan
2) Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
3) Department of Surgery, Otsu Municipal Hospital, Otsu, Japan
4) Department of Abdominal Surgery, Tenri Hospital, Tenri, Japan
5) Department of Surgery, Kyoto Katsura Hospital, Kyoto, Japan

Kazutaka Obama1)2), Koichi Matsuo1), Hiroshi Okabe3), Tsunehiro Yoshimura4), Dai Manaka5)

We conducted a questionnaire survey involving 28 major affiliated hospitals of Kyoto University (Kyoto University Affiliated Hospital Surgical Group of Cancer Research) regarding the perioperative management of elderly patients with gastrointestinal and hepato-biliary-pancreatic (HBP) cancers. We received responses from all 28 institutes (100％). Five institutes (18％) had introduced a periodical, multi-disciplinary cancer board meeting, and only 2 institutes (7％) systematically evaluated the operative risk of elderly patients using assessment tools such as E-PASS. Concerning the therapeutic strategy for elderly gastric cancer patients (>85 years old), 60％ of the institutes reduced the extent of lymphadenectomy (D2→D1+ or D1). On the other hand, for elderly esophageal cancer or HBP cancer patients (>80 years old), approximately most of the institutes aggressively performed radical esophagectomy, hepatectomy, and pancreaticoduodenectomy. Because most of the affiliated hospitals of our group had an aggressive policy of performing radical operations for elderly patients with gastrointestinal and HBP cancers, the introduction of systematic screening and rehabilitation programs for elderly patients with potential operative risks might be required in the future.

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