Prognostic significance of age in curatively resected gastric cancer

Abstract

4129 Background: Gastric cancer is the most common cancer and the second leading cause of cancer death in Korea. The aim of this study was to investigate the clinical significance of age in curatively resected gastric adenocarcinoma. Methods: Retrospective analysis was performed for 1,158 gastric cancer patients who underwent curative resection from Jan. 1996 to Dec. 2001. Results: Seven hundred sixy-seven (66.2%) of the patients were male and 391 (33.8%) were females. Median age was 56.9 ± 11.5 (range: 19–84). Total gastrectomy was performed in 13.6% and subtotal gastrectomy in 86.4%. Stage was as follows: I 59.4%, II 14.7%, IIIA 16.3%, IIIB 9.6%. Age less than 65 was 838 (72.4%) and ≥ 65 was 320 (27.6%). More than 65 years of age was associated with more tubular type (p=.001), intestinal Lauren type (p=.003), vascular invasion (p=.037), and higher T and total stage (p=.002). Operative complications were more common in age ≥ 65 group (p=.003), and also more frequent in early death rate in age ≥ 65 group (p=.020). Tumor recurrence was more common in age ≥ 65 group (p=.016). 2-, 4-, and 6-year total survival (TS) rates, and 2-, 4-, and 6-year relapse free survival (RFS) rates were 92.7%, 89.1%, 86.3% and 93.3%, 84.4%, 78.7% in age < 65 group and 89.4%, 84.8%, 71.1% (p=.012) and 90.3%, 81.5%, 75.1% (p=.122) in age ≥ 65 group respectively. By multivariate Cox regression analysis, tumor stage was the most important prognostic factor for TS and RFS. Age was an independent prognostic factor for predicting TS (RR 1.025, 95% CI 1.001–1.049), but, not a significant prognostic factor of RFS. But, after excludinga early death cases (within < 2 months of operation), prognostic significance of age was disappeared, and age was not independent prognostic factor for TS and RFS in curatively resected gastric cancer. Conclusions: So, we conclude that increased early death after curative resection causes poor prognosis in elderly gastric cancer patients. No significant financial relationships to disclose.