Cancer Res Treat.  2017 Jan;49(1):204-212. 10.4143/crt.2016.163.

Analysis of the Clinicopathological Characteristics of Gastric Cancer in Extremely Old Patients

• Sohn IW
• Jung DH
• Kim JH
• Chung HS
• Park JC
• Shin SK
• Lee SK
• Lee YC

• KMID: 2367518
• DOI: http://doi.org/10.4143/crt.2016.163

Abstract

PURPOSE
Gastric cancer is the third-leading cause of cancer-related death in Korea. As the Korean population is ageing, the number of extremely old patients with this disease is increasing. This study examined the clinicopathological characteristics of gastric cancer in extremely old (over 85 years) patients who received treatment or conservative observations and compared the treatment outcomes according to the treatment modality.
MATERIALS AND METHODS
A total of 170 patients over 85 years of age were diagnosed with gastric cancer. Of these, 81 underwent treatment for gastric cancer and 89 received conservative observations. The clinicopathological characteristics of the treatment and conservative groupswere compared.
RESULTS
The mean age of the patients was 86.5 years. The conservative group included significantly more patients with older ages, macroscopically advanced cancer and upper-middle located cancer. The overall survival rate of the treatment group was significantly higher than that of the conservative group. The disease-specific mortality rate was significantly lower in the treatment group than in the conservative group. Multivariate analysis revealed the clinical course, alarm sign, and macroscopic classification to be independent prognosis factors.
CONCLUSION
By itself, the chronological age should not be used as a strategy to determine whether treatmentwill be administered for gastric cancer. Patients who have early gastric cancer or lower-risk preexisting comorbidities should not be discouraged from treatment, even if they are older than 85 years.

Keyword

Oldest old; Aged; Stomach neoplasms; Therapy

MeSH Terms

Aged, 80 and over
Classification
Comorbidity
Humans
Korea
Mortality
Multivariate Analysis
Prognosis
Stomach Neoplasms*
Survival Rate

Figure

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  Fig. 1. (A) Overall survival rate of the treatment (n=81) and conservative (n=89) groups. (B) Disease-specific mortality of the treatment (n=81) and conservative (n=89) groups.

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  Fig. 2. The patients in the treatment group and the conservative group were divided into early gastric cancer (GC) and advanced GC subgroups (early and treatment group, n=34; early and conservative group, n=12; advanced and treatment group, n=47; and advanced and conservative group, n=77). (A) Overall survival rate with GC patients showing macroscopic classification and clinical course. (B) Disease-specific mortality rate with GC patients showing macroscopic classification and clinical course.

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  Fig. 3. (A) Overall survival rate of the treatment (n=81) and conservative (n=38) groups refused recommended treatment. (B) Disease-specific mortality of the treatment (n=81) and conservative (n=89) groups refused recommended treatment.

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  Fig. 4. The patients in the treatment group and the conservative group refused recommended treatment were divided into early gastric cancer (GC) and advanced GC subgroups (early and treatment group, n=34; early and conservative group, n=9; advanced and treatment group, n=47; and advanced and conservative group, n=29). (A) Overall survival rate with GC patients showing macroscopic classification and clinical course. (B) Disease-specific mortality rate with GC patients showing macroscopic classification and clinical course.

Reference

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