Surgical outcomes and survival of patients over 80 years old who underwent curative resection for gastric cancer.

Purpose: Among patients with gastric cancer who underwent radical gastrectomy, the proportion of patients aged ≥80 years has increased. This study aimed to evaluate surgical outcomes and survival of patients aged ≥80 years who underwent curative resection for gastric cancer and identify independent factors that affect postoperative survival. Methods: This retrospective study enrolled 1,066 patients aged ≥65 years with gastric cancer who underwent curative resection between January 2014 and December 2018 at a single institution. They were divided into those aged ≥80 years (old-elderly group) and 65-79 years (young-elderly group). Their clinicopathological characteristics and surgical outcomes were compared. Results: Of the 1,066 patients, 136 (12.8%) were 80 years or older. Higher American Society of Anesthesiologists (ASA) physical status classification and more advanced cancers were observed in the old-elderly group than in the young-elderly group. No significant difference in postoperative complications was found between the groups. At a median follow-up of 49.1 months, the 5-year overall survival rate after surgery for the old-elderly group was lower than that for the young-elderly group (75.6% vs. 87.0%, P < 0.001). However, the 5-year disease-specific survival rate was comparable between the groups (90.1% vs. 92.2%, P = 0.324). ASA physical status classification, pathologic stage, and surgical approach were independent predictors of overall survival. Conclusion: Old-elderly patients aged ≥80 years had comparable postoperative outcomes and disease-specific survival to the young-elderly group, suggesting that curative gastrectomy can be considered a viable option for octogenarian patients with gastric cancer.

Suppression of proinflammatory cytokine production by specific metabolites of Lactobacillus plantarum 10hk2 via inhibiting NF-κB and p38 MAPK expressions.

The objective of this study was to evaluate the immunomodulatory effects of specific bacterial metabolites of Lactobacillus plantarum 10hk2 to induce anti-inflammatory mediators in cell cultures of the murine macrophage cell line, RAW 264.7. The effects of the extracellular metabolites of this bacterial strain were examined by dividing them into protein and polysaccharide fractions. A specific protein fraction (8.7 kDa) was found to be a strong IL-10 inducer in LPS-stimulated RAW 264.7 cells and suppressed LPS-induced NF-κB induction and inhibited LPS-induced phosphorylation of I-κB and p38 MAPK. To the best of our knowledge, this was the first study that investigated the anti-inflammatory effects of an extracellular peptide derived from lactic acid bacteria. In addition, we characterized the inhibitory mode of this molecule in the induction of proinflammatory cytokines. Based on the findings presented in this study, this molecule holds promise for use as an agent to modulate inflammation related diseases.