Prognosis of Elderly Patients with Advanced Gastric Cancer without Serosal Invasion.

Ho Gun Kim, Jae Hyuk Lee, Dong Yi Kim
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Abstract

Introduction: The impact of age on the prognosis of patients with gastric cancer is controversial. This study aimed to investigate the clinicopathologic features and prognosis of elderly advanced gastric cancer patients without serosal invasion compared to their younger counterparts.

Materials and methods: We retrospectively evaluated 43 elderly patients with advanced gastric cancer without serosal invasion. The clinicopathologic findings were compared between the elderly (age >70 years) and young (age <36 years) patients.

Results: Significantly higher numbers of elderly patients had tumours with differentiated histology, whereas more young patients had tumours with undifferentiated histology (P < 0.01). Curability (risk ratio, 3.122; confidence interval, 1.242-4.779; P < 0.001) was an independent prognostic factor of survival. The 5-year survival rates were not significantly different between the elderly and the young patients according to the absence of serosal invasion (80.0% vs. 77.9%; P = 0.654) and undergoing curative resection (82.0% vs. 78.9%; P = 0.312). Meanwhile, among the elderly patients, those who underwent curative resection had a better survival rate than those with non-curative resection (82.0% vs. 67.8%; P < 0.001).

Conclusion: Elderly patients with advanced gastric cancer without serosal invasion do not have a worse prognosis than their younger counterparts, indicating that age does not impact the prognosis of advanced gastric cancer. The important prognostic factor was whether the patients underwent curative resection.

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无浆膜侵犯的老年晚期胃癌患者预后分析。
导读:年龄对胃癌患者预后的影响一直存在争议。本研究旨在探讨无浆膜侵犯的老年晚期胃癌患者与年轻晚期胃癌患者的临床病理特征及预后。材料与方法:回顾性分析43例高龄无浆膜侵犯的晚期胃癌患者。比较老年(>70岁)和年轻(>70岁)患者的临床病理表现。结果:老年患者组织学分化率明显高于年轻患者组织学未分化率(P < 0.01)。治愈率(风险比,3.122;置信区间为1.242-4.779;P < 0.001)是独立的预后因素。根据有无浆膜侵犯,老年和年轻患者的5年生存率无显著差异(80.0% vs 77.9%;P = 0.654)和行根治性切除(82.0% vs. 78.9%;P = 0.312)。同时,在老年患者中,行根治性切除的生存率高于非根治性切除的生存率(82.0% vs 67.8%;P < 0.001)。结论:老年无浆膜侵犯的晚期胃癌患者的预后并不比年轻患者差,说明年龄不影响晚期胃癌的预后。重要的预后因素是患者是否接受根治性切除。
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