Analysis of patient age and adjuvant chemotherapy (ACh) as predictor of survival in patients (pts) with resected gastric adenocarcinoma (RGA).

Abstract

e14518 Background: ACh and young age are favorable prognostic factrors in RGA. We retrospectively analysed the relationships of both factors in RGA pts. Methods: From 1977 and 2002, 430 consecutive patients with RGA were followed after ACh or after surgery without ACh .The ACh cosisted of mitomycin 10 mg/m2 (MMC) or MMC plus oral Tegafur, 500 mg/m2/day for six months. Grouping of age were 1=under 46 yrs 50 (12%) pts; 2=46 to 54 yrs 61 (14%) pts; 3=55 to 64 yrs 128 (30%) pts; and 4=over 64 yrs 191 (44%) pts. Results: Pts median age: 63 years (range 22-93). Gender, 277 (64%) male and 153 (36%) female. Tumor location was antrum, 186 (43%) pts, body 133 (31%) pts, cardia, 34 (8%) pts and not specified 77 (18%). Staging was node positive 247 (57%) pts or node negative 183 (43%) pts. ACh was given in 236 (55%) pts and did not in other 194 (45%). Median follow-up 76 moths. Significant differences in favor of the first subgroup in univariate analysis were node negative vs positive (p<0.0001); ACh vs no ACh in all pts (p<0.0001) and in group 3 (p<0.0001), group 4 (p=0.0002) and in group 3+4 (p<0.0001); a tendence of female vs male (p=0.0512), and group 4 vs 3 (p=0.0339) and group 1 vs 3 (p=0.0280). In a multivariate Cox analysis including age (over 63 vs less); gender (male vs female); stage (node positive vs negative); ACh global and group 3+4, only nodal stage (OR=3.34, 95% CI: 2.44-4.57, p<0.0001); global ACh (OR=0.38, 95% CI: 0.29-0.51, p<0.0001) and ACh in groups 3+4 (OR=0.31, 95% CI: 0.22-0.44, p<0.0001) were statistically significant. Conclusions: ACh is a predictive factor of favorable outcome in elderly pts with RGA.