Individualized preoperative assessment of the general condition of elderly patients with gastric cancer is necessary for appropriate surgical treatment planning. This study investigated the efficacy of preoperative markers that could be easily calculated from preoperative peripheral blood to predict the short- and long-term postoperative outcomes of gastrectomy. In total, 571 patients who underwent R0 surgical resection for gastric cancer were enrolled. In the elderly patient group (≥65 years old), univariate analyses revealed that the incidence of postoperative complications was associated with poor performance status (p= 0.012), more comorbidities (p= 0.020), high C-reactive protein to albumin ratio (CAR,p= 0.003), total gastrectomy (p= 0.003), open approach (p= 0.034), blood transfusion (p= 0.002), and advanced cancer (p= 0.003). Multivariate analysis showed that a high CAR was associated with a high incidence of postoperative complications (p= 0.046). High CAR was also associated with poor OS (p= 0.015) and RFS (p= 0.035). However, these trends were not observed among younger patients (<65 years old). Preoperative CAR may play a significant role in predicting short- and long-term surgical outcomes, particularly in elderly patients with gastric cancer.
对老年胃癌患者进行个体化的术前全身状况评估，是制定适宜手术治疗方案的必要前提。本研究旨在探讨基于术前外周血常规指标即可简便计算的术前标志物，对胃癌根治术后短期及长期预后的预测效能。研究共纳入571例接受R0手术切除的胃癌患者。在老年患者组（≥65岁）中，单因素分析显示术后并发症发生率与以下因素相关：体能状态较差（p=0.012）、合并症较多（p=0.020）、高C反应蛋白与白蛋白比值（CAR，p=0.003）、全胃切除术（p=0.003）、开腹手术（p=0.034）、输血治疗（p=0.002）以及进展期癌症（p=0.003）。多因素分析表明，高CAR值与术后并发症高发生率显著相关（p=0.046）。同时，高CAR值还与较差的总生存期（p=0.015）和无复发生存期（p=0.035）相关。然而，在年轻患者（<65岁）中未观察到上述关联趋势。术前CAR值对胃癌患者，特别是老年患者的短期及长期手术预后具有重要预测价值。
肿瘤(癌症)患者之家