A pooled analysis of the effect of age on adjuvant cisplatin-based chemotherapy for completely resected non-small cell lung cancer (NSCLC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7553-7553 ◽  
Author(s):  
M. Fruh ◽  
H. Tribodet ◽  
J. Pignon ◽  
T. Winton ◽  
T. Le Chevalier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Performance Status ◽  
Age Groups ◽  
Young Patients ◽  
Disease Free Survival ◽  
The Elderly ◽  
Pooled Analysis ◽  
Severe Toxicity ◽  
Cox Models

7553 Background: Adjuvant cisplatin-based chemotherapy (CT) has been shown to increase survival in NSCLC, but uncertainty exists concerning its efficacy and toxicity in elderly patients (≥ 70). Methods: We performed a pooled analysis using individual patient data from 4,584 patients in the LACE database with resected stage IA-III NSCLC enrolled in 5 randomized trials, comparing postoperative CT to no CT (ALPI, ANITA, BLT, IALT and JBR10). Patient and treatment characteristics, CT toxicity and delivery, overall survival, disease-free survival (DFS) and cause-specific mortality were compared among 3 age groups: 3,269 (71%) young (<65), 901 (20%) mid-category (65–69) and 414 (9%) elderly (≥70). The analysis was performed on an intent-to-treat basis. Cox models stratified by trials and adjusted for age, associated drug, planned radiotherapy, total dose of cisplatin (<300, 300, >300), gender, stage, performance status, type of surgery and histology were used with a test for trend to study the effect of CT on survival according to age. Results: Baseline characteristics differed among the age groups, but this was due mainly to the different trial populations and designs. No difference in severe toxicity rate was observed among the age groups. Elderly patients received significantly smaller total doses of cisplatin than the other patients (Chi2-test: p<0.0001) and also the cisplatin doses received were more often lower than the planned one (Kruskal-Wallis test: p<0.0001). The Hazard ratio (HR) of death for the young patients was 0.82 (95% CI 0.73–0.92), 0.86 (95% CI 0.70–1.07) for the mid category and 1.01 (95% CI 0.78–1.32) for elderly patients (test for trend: p=0.17). The HR for DFS was 0.79 (95% CI 0.71–0.87) for the young, 0.76 (95% 0.62–0.93) for the mid category and 0.94 (95% CI 0.73–1.22) for the elderly patients (test for trend: p=0.35). More elderly patients died from non- lung cancer related causes (10% young, 16% mid category and 20% elderly; p<0.0001). Conclusions: The survival benefit from cisplatin-based adjuvant therapy for NSCLC patients was not significantly different according to age, but this may be due to lack of power. Supported by unrestricted grants from PHRC and LNCC No significant financial relationships to disclose.

scholarly journals Chemotherapy Treatment of Elderly Patients (≥70 Years) with Non-Small Cell Lung Cancer: A Seven-Year Retrospective Study of Real-Life Clinical Practice at Karolinska University Hospital, Sweden

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Hirsh Koyi ◽  
Gunnar Hillerdal ◽  
Olov Andersson ◽  
Karl-Gustav Kölbeck ◽  
Per Liv ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Performance Status ◽  
Age Groups ◽  
Real Life ◽  
The Elderly ◽  
University Hospital ◽  
Nsclc Patients

An increasing proportion of cancer patients are aged >65 years and many are aged >70 years. Treatment of the elderly with lung cancer has, therefore, become an important issue; so we performed a retrospective study of our patients to demonstrate how elderly patients with NSCLC are treated in real-life, clinical practice. All patients aged ≥70 years with NSCLC at our department were reviewed retrospectively. In total, 1059 patients (50.8% of all NSCLC patients). Of these patients, 243 (22.9%) received chemotherapy, 164 (70.4%) of whom were treated with a platinum doublet using carboplatin. Second- and third-line chemotherapy were given to 31.4% and 13.9% of patients, respectively. Median overall survival was 289 and 320 days for male and female patients, respectively. Patients with performance status (PS) 0 experienced significantly better survival than patients with PS1 or PS 2: 410, 314, and 204 days, respectively. Age was of less importance, with patients aged 70–79 years versus those aged ≥80 years. Treatment of elderly NSCLC patients with chemotherapy is feasible if they have a good PS and appears to prolong survival. In this study, we found no significant differences in survival either between age groups or genders.

Oral chemotherapeutic agents in elderly acute myeloid leukemia (AML) patients, a study from a developing country

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7057-7057 ◽  
Author(s):  
S. Mukhopadhyay ◽  
P. Chitalkar ◽  
P. Gupta ◽  
U. Roy ◽  
A. Mukhopadhyay
Keyword(s):  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Developing Country ◽  
Myeloid Leukemia ◽  
Performance Status ◽  
Disease Free Survival ◽  
Normal Liver ◽  
The Elderly ◽  
Chemotherapeutic Agents ◽  
Acute Myeloid

7057 Background: Almost 60% of the patients with Acute Myeloid Leukemia (AML) are over the age of 60 years. Age is one of the strongest adverse prognostic factor for AML, both for induction remission and for survival. Studies have shown that elderly patients have reduced tolerance to aggressive chemotherapy especially the myelosupressive effects. Elderly patients with Leukemia who receive intensive treatment often die as a result of chemotherapy. Aggressive chemotherapy is also costly which the relatives in developing country are reluctant to spend for the elderly patients. The aim of our study was to see the outcome, tolerability and cost effectiveness of oral chemotherapeutic agents. Methods: We selected consecutive 100 patients more than 50 years of age in haemato oncology department of NCRI (Netaji Subhas Chandra Bose Cancer Research Institute) during the period from Jan 2004 to Dec 2006. The mean age of the patients was 65 (range 50 –71) years. There was male preponderance. The inclusion criteria were performance status more than 60% (Kornofsky), Morphological, Cyto-Chemical and Immunophenotyping diagnosis of Acute Myeloid Leukemia (AML), normal liver (billirubine < 2) and kidney function ( Creatinine <2%). After the incent consent all patient were started oral chemotherapeutic agents 6 Mercptopurine (6MP) 75mg/m2. Etoposide 70mg/m2 and Prednisolone 40mg/m2. All agents are given 3 weeks followed by 7 days gap every month and continued for 6 months. Bone Marrow was repeated after 3rd & 6th course of chemotherapy. Results: Fifteen (15%) and thirtyeight patients (38%) had complete hematological response after 3rd & 6th course of chemotherapy. Seven patients (7%) died because of grade III/IV Neutropenia. Median duration of Myelosupression was 18 days (2 to 48 days).12% required hospitalisation. With median follow up of 19 months (range 2–36 months) the disease free survival (DFS) and over all survival (OS) was 18 % and 32 % respectively. Conclusions: The combination of oral chemotherapeutic agents consisting of 6MP, Etoposide & Prednisolone were well tolerated by elderly patients with good induction remission, low mortality and median survival. It was cheaper and well accepted by the patients. No significant financial relationships to disclose.

Adjuvant or Palliative Chemotherapy for Colorectal Cancer in Patients 70 Years or Older

1999 ◽  
Vol 17 (8) ◽  
pp. 2412-2412 ◽  
Author(s):  
R. A. Popescu ◽  
A. Norman ◽  
P. J. Ross ◽  
B. Parikh ◽  
D. Cunningham
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Older Patients ◽  
Palliative Chemotherapy ◽  
Performance Status ◽  
Age Groups ◽  
Response Rates ◽  
The Elderly ◽  
Younger Patients ◽  
Royal Marsden Hospital

PURPOSE: The surgical treatment of colorectal cancer (CRC) in elderly patients (age 70 years or older) has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remain scarce. Elderly patients are underrepresented in clinical trials, and results for older patients are seldom reported separately. PATIENTS AND METHODS: Using a prospective database, we analyzed demographics, chemotherapy toxicity, response rates, failure-free survival (FFS), and overall survival (OS) of CRC patients receiving chemotherapy at the Royal Marsden Hospital. The cutoff age was 70 years. RESULTS: A total of 844 patients received first-line chemotherapy with various fluorouracil (5-FU)-containing regimens or raltitrexed for advanced disease, and 543 patients were administered adjuvant, protracted venous infusion 5-FU or bolus 5-FU/folinic acid (FA) chemotherapy. Of the 1,387 patients, 310 were 70 years or older. There was no difference in overall or severe (Common Toxicity Criteria III to IV) toxicity between the two age groups, with the exception of more frequent severe mucositis in older patients receiving adjuvant bolus 5-FU/FA. For patients receiving palliative chemotherapy, no difference in response rates (24% v 29%, P = .19) and median FFS (164 v 168 days) were detected when the elderly were compared with younger patients. Median OS was 292 days for the elderly group and 350 days for the younger patients (P = .04), and 1-year survival was 44% and 48%, respectively. The length of inpatient hospital stay was identical. CONCLUSION: Elderly patients with good performance status tolerated adjuvant and palliative chemotherapy for CRC as well as did younger patients and had similar benefits from palliative chemotherapy.

Erlotinib for Advanced Non–Small-Cell Lung Cancer in the Elderly: An Analysis of the National Cancer Institute of Canada Clinical Trials Group Study BR.21

2008 ◽  
Vol 26 (14) ◽  
pp. 2350-2357 ◽  
Author(s):  
Paul Wheatley-Price ◽  
Keyue Ding ◽  
Lesley Seymour ◽  
Gary M. Clark ◽  
Frances A. Shepherd
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Elderly Patients ◽  
National Cancer Institute ◽  
Age Groups ◽  
Young Patients ◽  
Progression Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival

PurposeNational Cancer Institute of Canada Clinical Trials Group Study BR.21 established erlotinib as a standard of care in patients with non–small-cell lung cancer (NSCLC) after failure of first- or second-line chemotherapy. The current study analyzes the influence of age on outcomes in BR.21.Patients and MethodsBR.21 was a double-blind phase III trial that randomly assigned 731 patients to erlotinib 150 mg daily or placebo. End points included progression-free survival and overall survival (OS), response, quality of life (QOL), drug exposure, and toxicity, which are analyzed in this retrospective study by the following two age groups: ≥ 70 years (elderly) or less than 70 years (young).ResultsThere were 163 elderly patients (112 on erlotinib, 51 on placebo) and 568 young patients (376 on erlotinib, 192 on placebo). There was no significant difference between age groups randomly assigned to erlotinib or placebo in progression-free survival (elderly: 3.0 v 2.1 months; hazard ratio [HR] = 0.63; 95% CI, 0.44 to 0.90; P = .009; young: 2.1 v 1.8 months; HR = 0.64; 95% CI, 0.53 to 0.76; P < .0001; interaction, P = .77) or OS (elderly: 7.6 v 5.0 months; HR = 0.92; 95% CI, 0.64 to 1.34; P = .67; young: 6.4 v 4.7 months; HR = 0.73; 95% CI, 0.61 to 0.89; P = .0014; interaction, P = .31). Response rates were similar between age groups. Elderly patients, compared with young patients, had significantly more overall and severe (grade 3 and 4) toxicity (35% v 18%; P < .001), were more likely to discontinue treatment as a result of treatment-related toxicity (12% v 3%; P < .0001), and had lower relative dose-intensity (64% v 82% received > 90% planned dose; P < .001).ConclusionElderly patients treated with erlotinib gain similar survival and QOL benefits as younger patients but experience greater toxicity.

Clinicopathological and molecular biological characteristics of early-onset stage II/III colorectal adenocarcinoma: An analysis of 25 studies with 47,184 patients (pts) in the adjuvant colon cancer end points (ACCENT) database.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4099-4099
Author(s):  
Zhaohui Jin ◽  
Jesse G. Dixon ◽  
Hiral D. Parekh ◽  
Steven R Alberts ◽  
Greg Yothers ◽  
...  
Keyword(s):  
Early Onset ◽  
Performance Status ◽  
Age Groups ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Braf Mutations ◽  
Cox Models ◽  
Related Data ◽  
Incidence And Mortality ◽  
The Difference

4099 Background: Colorectal cancer (CRC) incidence and mortality has decreased since the 1970s but the incidence is increasing in young adults (age 20-49). The incidence of early onset CRC (eoCRC) will keep increasing significantly based on the trends of the SEER CRC registry data. There is limited data suggesting eoCRC may have different behaviors compared to traditional CRC (tCRC, age ≥ 50). Methods: Individual pt data of 47184 stage II/III CRC pts from 25 randomized studies in the ACCENT database were pooled. The distributions of demographics, clinicopathological features, biomarker status, and treatment-related data were summarized by age group. Overall survival (OS), disease-free survival (DFS), recurrence-free rate (RFR), and survival after recurrence (SAR) were assessed by Kaplan-Meier curves and Cox models stratified by treatment arms within studies, adjusting for stage, performance status (PS), BMI and grade. Results: Using 5% difference between age groups as clinically meaningful cutoff, eoCRC had similar gender, race, ethnicity, PS, risk group, disease sidedness and T stage as tCRC. eoCRC were less likely overweight (30 vs 36%) and more pts had ≥ 12 lymph nodes resected (63 vs 51%). eoCRC had more frequent dMMR status (18 vs 12%), less BRAF mutations (5 vs 13%), and more dMMR/BRAF wild type (WT) status (17 vs 7%). Overall, eoCRC had better OS, DFS, and SAR, with the most significant differences between the < 30 and > = 70 age groups. Similar results were observed within pMMR pts. eoCRC experienced less hematological side effects, diarrhea, and stomatitis, but had more nausea and/or vomiting. Conclusions: eoCRC have unique characteristics; although statistically significant, the clinical differences in outcomes between eoCRC and tCRC are potentially due to the difference seen in extremely young and old pts. eoCRC have a different adverse events panel compared to tCRC. [Table: see text]

scholarly journals 109 Hyponatraemia in Older Patients is Often Untreated, Despite Greater Mortality Burden; Results of A Prospective Cohort Study

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i34-i36 ◽  
Author(s):  
O Thorpe ◽  
M Cuesta ◽  
W T Tormey ◽  
M Sherlock ◽  
D J Williams ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Prospective Observational Study ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Plasma Sodium ◽  
Single Centre ◽  
Similar Frequency ◽  
Mortality Burden

Abstract Introduction Hyponatraemia is associated with increased morbidity and mortality, and is commoner in elderly patients. The aetiology and outcomes of hyponatraemia in the elderly has not been defined in prospective studies. Methods A single-centre 9 month prospective observational study of hyponatraemic (HN) patients (&lt;/= 130 mmol/L) was performed. Clinical outcomes in patients ≥65 years (Elderly patients, EP) and those &lt;65 years (Young Patients, YP) were analysed, and compared with age-matched eunatremic controls, Analysis was performed using Graphpad-Prism 7. Results 1321 consecutive admissions with hyponatraemia (67% EP, median age of EP 77 (65–98) years) and 1122 eunatremic controls (63% EP, median age of EP 77 (65–99) years) were analysed. Median nadir plasma sodium was similar in both groups with HN, 128 (107–130) mmol/L EP vs 128(110–130) mmol/L YP (p = 0.62). EP hyponatraemic patients were more likely to have hypovolaemic hyponatraemia (34%) compared with YP with hyponatraemia (28%, p = 0.03). Diuretic-induced hyponatraemia was twice as common in EP (8%) compared with YP (4%, p = 0.01). Malignancy-induced SIAD occurred with similar frequency in both groups (7% in EP SIAD vs 8% in YP SIAD, p = 0.65). Respiratory disease was causative in 10% cases of EP SIAD, compared with 4% in YP SIAD, p = 0.0004. Hyponatraemia was corrected in 53% of EP, compared with 64% of YP, p = 0.0001. Length of stay and re-admissions rates were similar across hyponatraemia age groups. EP with HN were 2.4 times more likely to die in hospital, compared with eunatremic age-matched controls, (OR 2.4, 95% CI 1.6–3.7, p &lt; 0.0001). Conclusions The causation of hyponatraemia is different in elderly patients. Hyponatraemia in EP is often uncorrected, despite increased mortality compared with eunatremic age-matched controls.

Pooled Analysis of the Effect of Age on Adjuvant Cisplatin-Based Chemotherapy for Completely Resected Non–Small-Cell Lung Cancer

2008 ◽  
Vol 26 (21) ◽  
pp. 3573-3581 ◽  
Author(s):  
Martin Früh ◽  
Estelle Rolland ◽  
Jean-Pierre Pignon ◽  
Lesley Seymour ◽  
Keyue Ding ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pooled Analysis ◽  
Small Cell ◽  
Severe Toxicity ◽  
Event Free Survival ◽  
Small Cell Lung ◽  
Free Survival

PurposeThis pooled analysis was undertaken to assess the efficacy and toxicity of adjuvant cisplatin-based chemotherapy in elderly patients with non–small-cell lung cancer (NSCLC).MethodsWe used individual patient data from 4,584 patients enrolled onto five trials of cisplatin-based chemotherapy who form the basis for the Lung Adjuvant Cisplatin Analysis (LACE) pooled analysis. Patient and treatment characteristics, overall and event-free survival, cause-specific mortality, chemotherapy toxicity and delivery were compared among three age groups: 3,269 young (71%; < 65), 901 midcategory (20%; 65 to 69), and 414 elderly patients (9%; ≥ 70). Log-rank tests stratified by trials were used with a test for trend to study the effect of chemotherapy on survival according to age.ResultsThe hazard ratio (HR) of death for the young patients was 0.86 (95% CI, 0.78 to 0.94), 1.01 for the midcategory (95% CI, 0.85 to 1.21), and 0.90 for elderly patients (95% CI, 0.70 to 1.16; test for trend: P = .29). The HR for event-free survival was 0.82 for young (95% CI, 0.75 to 0.90), 0.90 for the midcategory (95% CI, 0.76 to 1.06), and 0.87 for elderly patients (95% CI, 0.68 to 1.11; test for trend: P = .42). More elderly patients died from non–lung cancer–related causes (12% young, 19% midcategory, 22% elderly; P < .0001). No differences in severe toxicity rates were observed. Elderly patients received significantly lower first and total cisplatin doses, and fewer chemotherapy cycles (χ2P < .0001).ConclusionAdjuvant cisplatin-based chemotherapy should not be withheld from elderly patients with NSCLC purely on the basis of age.

Adjuvant Chemotherapy for Non–Small-Cell Lung Cancer in the Elderly: A Population-Based Study in Ontario, Canada

2012 ◽  
Vol 30 (15) ◽  
pp. 1813-1821 ◽  
Author(s):  
Sinead Cuffe ◽  
Christopher M. Booth ◽  
Yingwei Peng ◽  
Gail E. Darling ◽  
Gavin Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adjuvant Chemotherapy ◽  
Elderly Patients ◽  
Survival Benefit ◽  
Age Groups ◽  
The Elderly ◽  
Small Cell ◽  
Small Cell Lung ◽  
Elderly Age ◽  
Hospitalization Rates

Purpose Non–small-cell lung cancer (NSCLC) is predominantly a disease of the elderly. Retrospective analyses of the National Cancer Institute of Canada Clinical Trials Group JBR.10 trial and the Lung Adjuvant Cisplatin Evaluation (LACE) meta-analysis suggest that the elderly benefit from adjuvant chemotherapy. However, the elderly were under-represented in these studies, raising concerns regarding the reproducibility of the study results in clinical practice. Patients and Methods By using the Ontario Cancer Registry, we identified 6,304 patients with NSCLC who were treated with surgical resection from 2001 to 2006. Registry data were linked to electronic treatment records. Uptake of chemotherapy was compared across age groups: younger than 70, 70 to 74, 75 to 79, and ≥ 80 years. As a proxy of survival benefit from chemotherapy, we compared survival of patients diagnosed from 2004 to 2006 with survival of those diagnosed from 2001 to 2003. Hospitalization rates within 6 to 24 weeks of surgery served as a proxy of severe chemotherapy-related toxicity. Results In all, 2,763 (43.8%) of 6,304 surgical patients were elderly (age ≥ 70 years). Uptake of adjuvant chemotherapy in the elderly increased from 3.3% (2001 to 2003) to 16.2% (2004 to 2006). Among evaluable elderly patients, 70% received cisplatin and 28% received carboplatin-based regimens. Requirements for dose adjustments or drug substitutions were similar across age groups. Hospitalization rates within 6 to 24 weeks of surgery were similar across age groups (28.0% for patients age < 70 years; 27.8% for patients age ≥ 70 years; P = .54). Four-year survival of elderly patients increased significantly (47.1% for patients diagnosed from 2001 to 2003; 49.9% for patients diagnosed from 2004 to 2006; P = .01). Survival improved in all subgroups except patients age ≥ 80 years. Conclusion Uptake of adjuvant chemotherapy for NSCLC increased in patients age 70 years or older following reporting of pivotal adjuvant chemotherapy trials, but it remained below that for patients younger than age 70 years. Adoption of adjuvant chemotherapy appears to be associated with significant survival benefit in the elderly (age ≥ 70 years), with tolerability apparently similar to that of patients who are younger than age 70 years.

scholarly journals Excess mortality and undertreatment in elderly lung cancer patients: treatment nihilism in the modern era?

2021 ◽  
pp. 00393-2020
Author(s):  
Jonathan Pham ◽  
Matthew Conron ◽  
Gavin Wright ◽  
Paul Mitchell ◽  
David Ball ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Mortality Risk ◽  
Excess Mortality ◽  
Cox Regression ◽  
Performance Status ◽  
Age Groups ◽  
Disease Stage ◽  
Cancer Treatments ◽  
Significant Difference

BackgroundTreatment of elderly patients with lung cancer is significantly hindered by concerns about treatment tolerability, toxicity and limited clinical trial data in the elderly – potentially giving rise to treatment nihilism amongst clinicians. This study aims to describe survival in elderly patients with lung cancer and explore potential causes for excess mortality.MethodsPatients diagnosed with lung cancer in the Victorian Lung Cancer Registry between 2011–2018 were analysed (n=3481). Patients were age-categorised and compared using Cox-regression modelling to determine mortality risk, after adjusting for confounding. Probability of being offered cancer treatments was also determined, further stratified by disease stage.ResultsThe eldest patients (≥80 years old) had significantly shorter median survival compared to younger age groups (<60: 2.0 years; 60–69: 1.5 years; 70–79: 1.6 years; ≥80: 1.0 years; p<0.001). Amongst those diagnosed with stage 1 or 2 lung cancer, there was no significant difference in adjusted-mortality between age groups. However, in those diagnosed with stage 3 or 4 disease, the eldest patients had an increased adjusted-mortality risk of 28% compared to patients younger than 60 years (p=0.005), associated with markedly reduced probability of cancer treatment, after controlling for sex, performance status, comorbidities and histology type (OR 0.24, compared to <60 years old strata, p<0.001).ConclusionCompared to younger patients, older patients with advanced-stage lung cancer have a disproportionately higher risk of mortality and lower likelihood of receiving cancer treatments, even when performance status and comorbidity are equivalent. These healthcare inequities could be indicative of widespread treatment nihilism towards elderly patients.

Clinicopathologic features of gastric cancer in the elderly population.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 33-33
Author(s):  
Joo Hyun Lim ◽  
Dong Ho Lee ◽  
Cheol Min Shin ◽  
Na Yung Kim ◽  
Young Soo Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Elderly Patients ◽  
Microsatellite Instability ◽  
Old Age ◽  
Age Groups ◽  
Young Patients ◽  
The Elderly ◽  
Age Group ◽  
P53 Overexpression ◽  
H Pylori

33 Background: Gastric cancer is one of the most common cancers, having great incidence among the elderly. However, little is known about gastric cancer in elderly patients. This study was designed to evaluate the specific features of gastric cancer in elderly patients. Methods: We reviewed medical records of 1107 patients who had undergone radical gastrectomy for gastric cancer between June 2005 and December 2009 retrospectively. They were divided into young age group (<65, n = 676), middle age group (65 ≤ age < 75, n = 332) and old age group (≥75, n = 99). To find out potential risk factors, these following factors were reviewed; symptoms, comorbidities, tumor marker levels, stages, H. pylori status, locations, Lauren type, differentiation, complications, microsatellite instability and p53 overexpression. Results: Elevated levels of CA 19-9 (5.6%, 13.4% and 14.6%, P = 0.001), advanced diseases (42.5%, 47.0% and 57.6, P = 0.014), and node metastasis (37.6%, 38.9% and 51.5%, P = 0.029) were more frequently detected in the middle and old age groups. However, no significant differences in H. pylori status (63.6%, 56.7% and 61.2%, P = 0.324) were observed among the three groups. Elderly patients had a tendency to show intestinal type in Lauren’s classification (40.7%, 58.7%, and 56.6%, P < 0.001). The rate of surgery-related complications did not differ among the three groups (5.3%, 5.1%, and 8.1%, P = 0.497). Microsatellite instability (P < 0.001) and p53 overexpression (P < 0.001) were more frequently found among the elderly patients. Conclusions: Gastric cancer in elderly patients was related to features known for favorable prognosis except p53 overexpression, despite the more advanced stage. Surgery in the elderly was as tolerable as in young patients. We recommend looking favorably upon surgery for elderly patients with operable gastric cancers.

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