Background: Although the current literature has shown an increasing interest in surgical treatment of gastric cancer (GC) in older adults in recent years, there is still no consensus on proper management in this subgroup of patients. This study was designed with the objective of evaluating the current evidence that compares limited lymph node dissection with extended lymph node dissection in older adult patients (≥65 years) coursing with resectable GC. Methods: A systematic review of PubMed, Cochrane library, and ScienceDirect was performed according to PRISMA guidelines. All studies before 2018 were selected using a systematic review by Mogal et al. Studies were eligible for this meta-analysis if they were randomized controlled trials or non-randomized comparative studies comparing limited lymph node dissection versus extended lymph node dissection in patients with resectable GC taken to gastrectomy. Results: Seventeen studies and a total of 5056 patients were included. There were not any statistically significant differences in OS (HR = 1.04, CI95% = 0.72–1.51), RFS (HR = 0.92, CI95% = 0.62–1.38), or CSS (HR = 1.24, CI95% = 0.74–2.10) between older adult patients taken to limited and extended lymphadenectomy in addition to gastrectomy as the current surgical treatment for GC. Although a higher rate of major complications was observed in the extended lymphadenectomy group, this difference was not statistically significant in incidence between both groups of patients (OR = 1.92, CI95% = 0.75–4.91). Conclusions: Limited lymphadenectomy must be considered as the better recommendation for surgical treatment for GC in older adult patients, considering the oncological outcomes and lower rates of complications compared with more radical lymph node dissections.

Background: Population ageing has increased the number of very old adults undergoing abdominal surgery. In this group, outcomes beyond mortality and morbidity, including functional status and quality of life, are highly relevant. The EuroQol 5D-3L questionnaire is widely used, but evidence of its psychometric performance in patients aged 80 years and older undergoing surgery remains limited. This study evaluated its measurement properties in this population. Methods: A scale validation study was conducted. Health status was measured using the EuroQol 5D-3L questionnaire and its visual analogue scale. Structural validity was examined using exploratory and confirmatory factor analyses based on polychoric correlations. Internal consistency was assessed using Cronbach alpha and McDonald omega. Short-term stability and construct validity were evaluated using agreement coefficients and correlations with depressive symptoms and clinical severity. Results: 388 patients were included, with a mean age of 84.32 years (SD = 3.4). Factor analyses supported a bidimensional structure separating physical functioning from mental and affective health, with better fit for the two factor model. Internal consistency was Cronbach’s alpha of 0.83 and McDonald’s omega of 0.90. A ceiling effect was observed in 32% of participants. Agreement over 15 days was low for EQ-5D-3L dimensions and absent for overall perceived health measured with the EQ-VAS. Small to moderate correlations with depressive symptoms and weak associations with clinical severity supported construct validity. Conclusions: The EQ-5D-3L demonstrated acceptable psychometric performance for assessing self-reported health status in very old surgical patients, supporting its use in clinical evaluation and outcomes research in geriatric surgical care.