Age and Outcome in Gastrointestinal Cancers: A Population-Based Evaluation of Oesophageal, Gastric and Colorectal Cancer

Abstract

Background: With demographic changes and partial representativeness of randomized studies the question arises which results are achieved in the treatment of the elderly. The objective was to analyse population-based data on gastrointestinal cancers in terms of age. Methods: Analyses included data of the Munich Cancer Registry, i.e. 4,014, 10,127 and 42,809 invasive oesophageal, gastric and colorectal cancer patients, respectively, which were diagnosed between 1998 and 2014. Tumour characteristics and outcome were analysed by age groups and therapy. Overall survival was analysed using the Kaplan-Meier method, and relative survival was computed as estimation for cancer-specific survival. Additionally, conditional survival of patients surviving at least 6 or 12 months was analysed by age. Results: 21, 44 and 38% of oesophageal, gastric and colorectal cancer patients, respectively, were aged >75 years. Of these, 15, 46 and 73% were surgically treated with curative intent, respectively, which is significantly less than in younger patients. The total 5-year relative survival was 24, 33 and 66%, respectively. The differences in median survival by age group were diminished by selecting those surviving at least 6 or 12 months and those with curatively intended treatment. Conclusion: An adequate patient selection for therapies of these gastrointestinal cancers was demonstrated at large. If the patients' general conditions allowed curatively intended treatment, it was applied and led to similar outcomes irrespective of age.

Local and Systemic Interleukin-32 in Esophageal, Gastric, and Colorectal Cancers: Clinical and Diagnostic Significance

“…The discrepancy between the level of gene transcripts and protein is quite a frequent occurrence [ 29 ], previously observed for our patients with respect to expression of immunosuppressive IL-4 and IL-13 [ 22 ]. The phenomenon is explained by varying half-lives of mRNA and protein as well as by various posttranslational modifications which may further increase protein stability [ 29 ]. IL-32 expression has been repeatedly shown to be regulated by microRNAs [ 30 , 31 ], known to affect gene expression at transcriptional and/or translational level [ 32 ].…”

“…IL-32 expression has been repeatedly shown to be regulated by microRNAs [ 30 , 31 ], known to affect gene expression at transcriptional and/or translational level [ 32 ]. In fact, it has been suggested that transcriptomic and proteomic data should be treated as separate source of information [ 29 ]. In case of our study, the discrepancy might be associated with uncertainty of detected IL-32 isoforms.…”

Design and virtual implementation of a biomedical registry framework for the enhancement of clinical trials: colorectal cancer example

“…Generally, the reliability of the research results is increased when standards are followed (including the specific disease of the patient population, similar approaches to treatment protocols, similar staging and specific age ranges), according to https://clinicaltrials.gov/ct2/about-studies/learn (last accessed November 2018). As an example, recent studies of colorectal cancer (CRC) have demonstrated that careful and effective patient selection can lead to many useful conclusions for both clinical trials and therapeutic approaches 2 3. It is noteworthy that personal demographic characteristics have an effect on participation in biomedical research.…”

Oxaliplatin-Induced Lhermitte’s Sign in Gastric Cancer

“…On the other hand, no reports of OLS in gastric cancer patients were found in a search of the Japanese literature (on Ichushi) despite a similar number of gastric and colorectal cancer patients in Japan. Second, the faster progression and worse prognosis of gastric cancer may make it less likely for patients to reach the dose-limiting toxicity before experiencing progressive disease [27]. Third, XELOX (capecitabine+oxaliplatin) is used more commonly in gastric cancer than FOLFOX (5-fluorouracil+folinic acid+oxaliplatin), which is frequently used in colon cancer.…”