Gastric Cancer in Older Patients: A Retrospective Study and Literature Review

Abstract

Background: With increasing life expectancy, the incidence of gastric cancer (GC) in older adults is increasing. This study analyzed differences in GC characteristics according to age and sex among patients who underwent surgical treatment for GC.Methods: A total of 2,983 patients diagnosed with gastric adenocarcinoma who underwent surgical treatment at Seoul National University Bundang Hospital between 2003 and 2017 were classified into three groups: I (<65 years, n=1,680), II (60–74 years, n=919), and III (≥75 years, n=384). We compared the baseline clinical characteristics, pathological characteristics of the tumor, overall and GC-specific survival rates, and associated risk factors between the groups.Results: Cancer of the distal third of the stomach (p<0.001), with intestinal-type histology (p<0.001), and with p53 overexpression (p=0.004) were more common in groups II and III than in group I, and the proportion of intestinal-type GC increased with age. The cancer type, lymph node metastasis, and cancer stage did not differ significantly. In terms of overall survival, survival decreased with increasing age (p<0.001), but this difference decreased significantly for GC-specific survival. Cox multivariate analyses revealed age, histologic type (diffuse or mixed type), and advanced cancer stage (p=0.002, 0.001, and <0.001, respectively) as risk factors for GC-related mortalityConclusion: Age itself was found to be one of the most important prognostic factors for overall and disease-specific survival in elderly GC patients, along with cancer stage.

The Effect of Neuromuscular Blockade Reversal Agents on Postoperative Pulmonary Complications in Patients undergoing Femur Fracture Repair Surgery: A Retrospective Observational Study

“…Some variables identified as risk factors in this study, including higher ASA PS, higher age, and lower preoperative saturation, were also representative risk factors for PPCs in previous studies. 25 - 27 ) In particular, the latter two are meaningful components of the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, the only validated method for scoring PPCs risk factors. Therefore, efforts to identify risk factors using various methods, such as prospective or large-scale studies, are necessary.…”

Comparable prognosis of early gastric cancer between intestinal type and diffuse type in patients of age 75 and older: a SEER-based cohort study

“…More than a third of new GC cases are patients aged 75 years and older ( 4 ). Several previous studies have reported that elderly GC patients often show a poorer survival than that of younger patients ( 5 , 6 ). Notably, studies have also found that the overall survival of elderly patients is significantly worse than that of younger patients after gastrectomy ( 7 , 8 ).…”

Understanding the role of gut microfloral bifidobacterium in cancer and its potential therapeutic applications

“…They included three different age groups in the study: groups I, II, and III, with ages of < 65 years, 60-74 years, and > 75 years, respectively. Groups II and III showed significantly lower survival, indicating a vital role of age in gastric cancer [ 51 ] . American Society of Clinical Oncology also describes age as one of the risk factors for gastric cancer.…”