A comparison of patient characteristics, prognosis, treatment modalities, and survival according to age group in gastric cancer patients

Background: The aim of this study was to investigate age-specific incidence rates and to compare diseasestage, treatment, and survival according to age group in patients with gastric adenocarcinoma. Methods: Gastric cancer patients treated at our hospital between 1999 and 2010 were retrospectivelyevaluated. We divided the cases into two subgroups: group 1 consisted of patients older than70 years at the time of treatment, and group 2 included patients aged 70 years or younger. Inall, 151 patients over 70 years of age and 715 patients age 70 years or younger wereanalyzed. Categorical and continuous variables were summarized using descriptive statisticsand compared using statistical software. Overall survival rates were estimated via the Kaplan-Meier method. Results: Median age at diagnosis was 58 years (range: 22 to 90 years). Between 1999 and 2002 theannual median age for patients aged older than70 years was 9.8%, which increased to 20%between 2007 and 2010. The one-year survival rate for patients with metastatic disease (stageIV) was 10.9% (95% CI: 8.9% to 12.9%) and 27.8% (95% CI: 17.3% to 38.2%) in groups 1and 2, respectively (P = 0.015). The five-year survival rate for patients with non-metastaticdisease (in whom curative surgery was performed) was 15.5% (95% CI = 12% to 19%) and26.9% (95% CI = 25.9% to 27.9%) in groups 1 and 2, respectively (P = 0.03). There were nosignificant differences in gender, tumor localization in the stomach, tumor histology,perineural invasion (PNI), lymphovascular invasion (LVI), tumor stage, or type of surgerybetween the two groups. However, fewer of the patients in group 1 underwent adjuvanttreatment (P = 0.02) and palliative chemotherapy (P = 0.007) than group 2 patients that werenon-metastatic and metastatic at presentation, respectively. Conclusions: Groups 1 and 2 were similar in terms of histopathological features and surgical modality;however, the survival rate was lower in group 1 than in group 2. The incidence of gastriccancer was higher in the patients older than 70 years of age. Additional randomized studiesare needed to further assess the safety and clinical benefit of chemotherapy in gastric cancerpatients older than70 years of age.

via World Journal of Surgical Oncology