J Gastric Cancer.  2016 Dec;16(4):260-265. 10.5230/jgc.2016.16.4.260.

Could Adjuvant Chemotherapy after Surgery Benefit Elderly Patients with Advanced Gastric Cancer?

• Jeong JW
• Kwon IG
• Son YG
• Ryu SW

• KMID: 2389852
• DOI: http://doi.org/10.5230/jgc.2016.16.4.260

Abstract

PURPOSE
The aim of this study was to evaluate tolerance to adjuvant chemotherapy, and to compare survival between treatments using only surgery and using surgery with adjuvant chemotherapy, in elderly patients with advanced gastric cancer who were ≥75 years of age.
MATERIALS AND METHODS
Patients ≥75 years of age who were diagnosed with pathological stage II or III gastric cancer were identified retrospectively and categorized into the surgery only and surgery with adjuvant chemotherapy groups. Clinicopathological and survival data were compared between these two groups.
RESULTS
Among the 130 patients studied, 67 patients underwent curative surgery only, and 63 patients received adjuvant chemotherapy after curative surgery. In the latter group, adverse events were reported in 24 patients (38.1%). The treatments were discontinued in 19 patients (30.2%) owing to any reason. The overall 5-year survival rates of the surgery only and the surgery with adjuvant chemotherapy groups did not differ significantly (44.1% vs. 30.7%, respectively; P=0.804). Among 90 death events, deaths from recurrences of gastric cancer occurred in 42 patients. Multivariate analyses revealed that the American Society of Anesthesiologists score and the depths of tumor invasions were related to survival, and the addition of adjuvant chemotherapy after surgery did not influence survival.
CONCLUSIONS
The decision for the addition of adjuvant chemotherapy for elderly patients should be taken after considering the condition of individual patients and their life expectancies.

Keyword

Aged; Chemotherapy; Adjuvant; Gastrectomy; Stomach neoplasms

MeSH Terms

Aged*
Chemotherapy, Adjuvant*
Drug Therapy
Gastrectomy
Humans
Life Expectancy
Multivariate Analysis
Recurrence
Retrospective Studies
Stomach Neoplasms*
Survival Rate

Figure

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  Fig. 1 Flowchart for inclusion of patients in this study. *Classification according to the American Joint Committee on Cancer 7th edition.

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  Fig. 2 Survival graphs. Comparison of (A) cumulative overall survival, and (B) cumulative disease-specific survival between the surgery only and surgery with adjuvant chemotherapy groups.

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  Fig. 3 The causes of deaths with respect to the times after surgery. The values are represented percent in the graph.

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