Impact of Age on the Prognosis of Operable Gastric Cancer Patients

Abstract

To investigate the impact of age on the clinicopathological features and survival of patients with gastric cancer (GC), and hope to better define age-specific patterns of GC and possible associated risk factors.Using the surveillance, epidemiology, and end results (SEER) database to search the patients who diagnosed GC between 2007 and 2011 with a known age. The overall and 5-year gastric cancer specific survival (CSS) data were obtained using Kaplan–Meier plots. Multivariable Cox regression models were built for the analysis of long-term survival outcomes and risk factors.A total of 7762 GC patients treated with surgery during the 4-year study period were included in the final study cohort. We divided into five subgroups according to the different age ranges. The overall 5-year cause-specific survival (CSS) was 60.3% in Group 1 (below 45 years), 60.3% in the Group 2 (45–55 years), 61.2% in Group 3 (56–65 years), 59.2% in Group 4 (66–75 years), and 59.2% in Group 5 (older than 76 years). Kaplan–Meier plots showed that patients older than 76 years had the worst 5-year CSS of 56.0% rate in all the subgroups. Age, tumor size, primary site, histological type, and Tumor Node Metastasis stage were identified as significant risk factors for poor survival on univariate analysis (all P < 0.001, log-rank test). Additionally, as the age increased, the risk of death for GC demonstrated a significant increase.In conclusion, our analysis of the SEER database revealed that the prognosis of GC varies with age. Patients at age 56 to 65 group have more favorable clinicopathologic characteristics and better CSS than other groups.

Age-specific impact on the survival of gastric cancer patients with distant metastasis: an analysis of SEER database

“…In China, GC is the second leading cause of cancer death, and the current 5 year CSS is low because more than 80% of patients are diagnosed at an advanced stage [ 15 - 16 ]. Age is considered as one of the independent factors of several cancers [ 6 - 9 , 12 ]. Investigation of important prognostic factors of GC development could further understand and improve the treatment of the advanced disease.…”

“…The current definition of elderly patients remains controversial. Some studies used the cutoff age of 50 years, while others used 30 years or 45 years [ 6 , 8 - 9 , 17 ]. In this study, we divided GC patients into young (≤60) and elderly (>60) groups according to recent publications and the new age subsection-standard of the United Nations world health organization [ 8 - 9 ].…”

“…It has been suggested that young patients suffered worse survival due to the characteristics of themselves and different tumor behavior [ 20 ]. Chen et al [ 9 ] reported that between 56 and 65 years have more favorable clinicopathologic characteristics and better CSS than the other groups in operable gastric cancer patients. While Song et al [ 8 ] argued that the prognosis of GC varied with age, and young patients suffered a higher survival rate after surgery compared to elderly patients.…”

“…Age has been recognized as an important predictor of prognosis in many cancers [ 6 - 7 ]. The prevalence of GC increases with age, and the peak incidence is in old population of 60-70 years [ 8 - 9 ]. Clarification of the relationship between age and GC survival could reveal the impact of age on cancer prognosis and improve treatment efficacy [ 10 ].…”

“…Similar results were also found in Li's study [ 6 ], where young patients with colorectal cancer after surgery had a higher cancer specific survival (CSS) rate than elderly ones [ 6 ]. Although the survival and age at diagnosis in GC has been investigated [ 8 - 9 , 13 ], age-specific impact on the survival in GC patients with distant metastasis (M1) is still unclear. In this study, we compared the pathological characteristics and prognostic outcomes of GC with M1 in young patients with elderly ones based on Surveillance, Epidemiology, and End Results (SEER) population-based data.…”