Is advanced age a barrier to effective cancer treatment? The experience of nonagenarians receiving radiation therapy

Thompson, Andrew; Cone, Rebecca; Gao, Helen G. L.; Hammond, Elizabeth; Fraser, D M; Back, Michael

doi:10.1111/j.1743-7563.2011.01497.x

Cited by 10 publications

(9 citation statements)

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“…One reason for under-treatment could be due to clinicians' frequent underestimation of the life expectancy of the elderly; another could be limitations in economic resources. Additionally, the omission of the elderly from clinical trials and the subsequent lack of evidence for treatment of elderly patients have been criticised [18,29].…”

Section: Discussionmentioning

confidence: 99%

Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry

et al. 2015

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Background Gastric cancer accounts for 5 % of cancer deaths. Proportions of older stomach cancer patients are increasing. Despite the still poor prognosis, standardised treatment has achieved improvements; nonetheless it is questionable whether all age groups have benefitted. Age and outcome need to be examined in a population-based setting. Methods Analyses included Munich Cancer Registry (MCR) data from 8601 invasive gastric cancer patients, diagnosed between 1998 and 2012. Tumour and therapy characteristics and outcome were analysed by two age groups (\70 vs. C70 years). Survival was analysed using the Kaplan-Meier method and relative survival was computed as an estimation for cancer-specific survival.Additional landmark analyses were conducted by calculating conditional survival of patients who survived more than 6 months. Results Fifty-nine per cent of the cohort were C70 years old. These patients had tumours with a slightly better prognosis and were treated with less radical surgery and adjuvant therapy than younger patients. The 5-year relative survival was 40 % for the youngest (\50 years) and 23 % for the oldest patients (C80 years). Survival differences were diminished or eliminated after landmark analyses:The 5-year relative survival in age groups 50-59, 60-69 and 70-79 years was comparable (between 48 and 49.6 %) and slightly worse in the youngest and oldest (45 %), which may be explained by more aggressive tumours and effects of cellular senescence, respectively. Conclusion 123Gastric Cancer (2016( ) 19:713-722 DOI 10.1007 resection and chemotherapy, it is conducted and the result is comparable between age groups.

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Section: Discussionmentioning

confidence: 99%

Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry

et al. 2015

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“…Treatment for elderly GC patients has been criticized. 35 Factors such as comorbidity and decreased functional status may influence the selection of treatment strategies for elderly patients. One of the main concerns with gastrectomy in the elderly is palliative operation or radical dissection.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and prognosis in elderly gastric cancer patients: a retrospective cohort study

Feng

Liu

et al. 2018

OTT

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BackgroundLittle is known about the clinicopathological features and prognosis in elderly gastric cancer (GC) patients aged 65–79 years. The aim of this study was to evaluate clinicopathological features and prognosis in elderly GC patients.Patients and methodsFrom May 2008 to December 2014, a total of 5,282 GC patients were enrolled in our present study. Patients were divided into elderly and middle-aged groups. The clinicopathological features and clinical outcomes were analyzed.ResultsThe proportion of dysphagia was significantly higher in elderly patients than that in middle-aged patients (P=0.002), whereas the proportion of abdominal pain and heartburn was significantly lower in elderly patients than that in middle-aged patients (P<0.001 vs P=0.038, respectively). The proportion of patients with carbohydrate antigen (CA) 19-9 was significantly higher in elderly patients than that in middle-aged patients (P=0.009). There was no significant difference in clinicopathological features between elderly and middle-aged patients with D2 gastrectomy (all P>0.05). Age, tumor size, histological type, tumor depth, lymph node metastasis, carcinoembryonic antigen, alpha fetoprotein, CA19-9, and CA125 were independent risk factors for the prognosis of GC patients in univariate and multivariate analyses. Overall survival in elderly patients was significantly reduced compared with middle-aged patients (P=0.001), especially in patients with tumor size >5 cm (P=0.002), poorly differentiated tumor (P<0.000), stage III tumor (P=0.002), or normal levels of carcinoembryonic antigen (P=0.009), alpha fetoprotein (P=0.002), CA19-9 (P=0.002), and CA125 (P=0.004).ConclusionThe clinicopathological features of elderly patients were different to those of middle-aged patients. The prognosis for elderly GC patients was significantly worse than for middle-aged patients.

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“…[14][15][16] The limited number of existing publications often included low numbers of elderly patients 17 or were small, [14][15][16] included palliative treatments, [14][15][16] or were limited by short follow-up time. 16 The outcomes of our study may be affected by selection bias and inclusion of the "well" old; 70% of the patients in our study had an ECOG PS score of 0 or 1 and 72% had a CCMI score of 0. In contrast, a study of comorbid conditions in patients with breast cancer who were over the age of 80 years found that only 35% of patients were free of common comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

Tolerability and outcomes of curative radiotherapy in patients aged 85 or more years

Khor

Bressel

Tedesco

et al. 2015

Medical Journal of Australia

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Is advanced age a barrier to effective cancer treatment? The experience of nonagenarians receiving radiation therapy

Abstract: Nonagenarian patients receiving treatment had satisfactory tolerability and achieved expected survival rates post-RT.

Cited by 10 publications

References 10 publications

Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry

Outcome of gastric cancer in the elderly: a population-based evaluation of the Munich Cancer Registry

Clinicopathological features and prognosis in elderly gastric cancer patients: a retrospective cohort study

Tolerability and outcomes of curative radiotherapy in patients aged 85 or more years

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